Individual
ALYCIA ROSE MATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7631
Mailing address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7631
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
058071
NY
Other
Enumeration date
07/17/2013
Last updated
06/30/2014
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