Individual
MR. BRUCE ROBERT ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
750 E ADAMS ST, SUNY UPSTATE MEDICAL UNIVERSITY, DEPT. OF NEUROSURGERY, SYRACUSE, NY 13210-2342
(315) 464-4470
Mailing address
750 EAST ADAMS ST., SUNY UPSTATE MEDICAL UNIVERSITY, DEPT. OF NEUROSURGERY, SYRACUSE, NY 13210
(315) 464-4470
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
003704-1
NY
Other
Enumeration date
10/02/2006
Last updated
05/28/2010
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