Individual
JOHN P DESIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 IRVING AVE, STE 300, SYRACUSE, NY 13210-1528
(315) 464-4686
(315) 464-7106
Mailing address
475 IRVING AVE, STE 300, SYRACUSE, NY 13210-1528
(315) 464-4686
(315) 464-7106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
104285
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00482453
—
NY
01
—
4216626
AETNA
—
Enumeration date
07/17/2006
Last updated
07/08/2007
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