Individual
BETHANY LYNN AZZARELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7411
Mailing address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7411
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
016983
NY
Other
Enumeration date
09/16/2013
Last updated
12/08/2015
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