Individual
DANA L.. OVIATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1001 JAMES ST, SYRACUSE, NY 13203-2707
(315) 428-0016
(315) 478-3913
Mailing address
109 MARANGALE RD, MANLIUS, NY 13104-1008
(315) 682-2993
(315) 478-3913
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
001163
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01368309
—
NY
01
—
J400043589
MEDICARE PTAN
NY
Enumeration date
10/19/2005
Last updated
01/13/2012
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