Organization
CNY CHILD NEUROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY J HAVERNICK M.D. (OWNER)
(315) 446-2985
Entity
Organization
Contact information
Practice address
5850 HERITAGE LANDING DR, EAST SYRACUSE, NY 13057-9359
(315) 446-2985
Mailing address
5850 HERITAGE LANDING DR, EAST SYRACUSE, NY 13057-9359
(315) 446-2985
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
159000
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00845905
—
NY
Enumeration date
12/18/2007
Last updated
12/18/2007
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