Individual
MINA VIGBEDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
RN
Contact information
Practice address
620 MADISON ST, SYRACUSE, NY 13210-2319
(315) 426-3600
Mailing address
705 FERN RD, SYRACUSE, NY 13219-2219
(774) 253-1510
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
746624-01
NY
Other
Enumeration date
03/22/2025
Last updated
03/22/2025
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