Organization
THER CENTERS AT ST. CAMILLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIA VENESE ROSS-HARDY (ILST)
(315) 703-0685
Entity
Organization
Contact information
Practice address
813 FAY RD, SYRACUSE, NY 13219-3009
(315) 703-0685
(315) 488-3804
Mailing address
813 FAY RD, SYRACUSE, NY 13219-3009
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
11/26/2013
Last updated
04/30/2015
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