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Individual

REBECCA GAVETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
505 IRVING AVE, SUNY UPSTATE MEDICAL UNIVERSITY, SYRACUSE, NY 13210-1718
(315) 464-2320
Mailing address
505 IRVING AVE, SUNY UPSTATE MEDICAL UNIVERSITY, SYRACUSE, NY 13210-1718

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
021227
NY

Other

Enumeration date
07/13/2015
Last updated
07/13/2015
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