Individual
MR. DYLAN RODNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5000 BRITTONFIELD PKWY, SUITE A100, EAST SYRACUSE, NY 13057-9226
(315) 449-3800
(315) 449-1246
Mailing address
1001 W FAYETTE ST, SUITE 400, SYRACUSE, NY 13204-2859
(315) 449-3800
(315) 449-1246
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
001653
CT
363AM0700X
Medical Physician Assistant
Primary
008762
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008762
STATE LICENSE
NY
Enumeration date
03/23/2007
Last updated
03/12/2021
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