Individual
ANDREW TADDEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 ERIE BLVD E, SYRACUSE, NY 13210-1144
(315) 422-4412
(315) 422-4690
Mailing address
8574 BURNET RD, CLAY, NY 13041-9412
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C0038721
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01007758
—
NY
Enumeration date
08/09/2006
Last updated
02/21/2008
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