Individual
DIANE MARIE WILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 IRVING AVE, SYRACUSE, NY 13210-2716
(315) 425-4400
Mailing address
800 IRVING AVE, SYRACUSE, NY 13210-2716
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005869-1
NY
Other
Enumeration date
11/17/2006
Last updated
07/16/2007
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