Individual
TERESA MENKE HARGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH, FAAP
Contact information
Practice address
742 JAMES ST, SYRACUSE, NY 13203-2017
(315) 703-2800
(315) 703-2885
Mailing address
742 JAMES ST, SYRACUSE, NY 13203-2017
(315) 703-2800
(315) 703-2885
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
117677
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
117677
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01076113
—
NY
Enumeration date
04/07/2006
Last updated
07/06/2009
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