Individual
REBECCA JEAN WALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
719 HARRISON ST, SYRACUSE, NY 13210-2305
(315) 464-5631
Mailing address
709 WOODS RD, VESTAL, NY 13850-3567
(607) 761-4701
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403668
NY
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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