Individual
MR. BRETT A HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-5612
Mailing address
4678 STATE ROUTE 364, RUSHVILLE, NY 14544-9721
(585) 746-0837
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
346206
NY
363LF0000X
Family Nurse Practitioner
Primary
F346206-01
NY
Other
Enumeration date
08/10/2020
Last updated
07/17/2023
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