Individual
RICHARD R WAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
961 CANAL ST, SYRACUSE, NY 13210-1203
(315) 478-1977
Mailing address
961 CANAL ST, SYRACUSE, NY 13210-1203
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
208466
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02172030
—
NY
01
—
208466-3B
WORKERS' COMPENSATION
NY
Enumeration date
05/23/2005
Last updated
03/25/2010
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