Individual
PHITSAMAI THATVIHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
725 E ADAMS ST STE 1A, SYRACUSE, NY 13210-2576
(315) 464-7842
(315) 464-7840
Mailing address
725 E ADAMS ST STE 1A, SYRACUSE, NY 13210-2576
(315) 464-7842
(315) 464-7840
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
339735
NY
Other
Enumeration date
01/14/2016
Last updated
07/25/2025
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