Individual
SHICOREN M ADAMS I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
YPA CREDIENTIAL
Contact information
Practice address
215 WYOMING ST, SYRACUSE, NY 13204-2927
(315) 703-8700
Mailing address
215 WYOMING ST STE 202, SYRACUSE, NY 13204-2928
(315) 406-8564
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175T00000X
—
NY
Enumeration date
04/12/2022
Last updated
04/12/2022
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