Individual
BUKRIYA OTHMAN IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-5540
Mailing address
6273 ADDISON LOOMIS, CICERO, NY 13039-8685
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
787254
NY
363LF0000X
Family Nurse Practitioner
Primary
356925
NY
Other
Enumeration date
04/28/2025
Last updated
06/04/2025
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