Individual
BRANT FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-4550
(315) 464-6250
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-4550
(315) 464-6250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001840
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02799773
—
NY
01
—
P00424698
RAILROAD MEDICARE
NY
Enumeration date
06/05/2006
Last updated
08/27/2013
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