Organization
CROUSE MEDICAL PRACTICE PLLC
Active
Other names
Internist Associates of Central New York Clinical Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
KIM DEC (PRACTICE MANAGER)
(315) 701-2550
Entity
Organization
Contact information
Practice address
739 IRVING AVE, SUITE 350, SYRACUSE, NY 13210-1651
(315) 479-5070
(315) 701-2520
Mailing address
730 S CROUSE AVE, SUITE 204, SYRACUSE, NY 13210-1754
(315) 479-5070
(315) 701-2520
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
33D0166447
NY
Other
Enumeration date
09/29/2010
Last updated
02/14/2011
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