Individual
CARMEN J FEDERICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
311 GREEN ST, SYRACUSE, NY 13203-2911
(315) 425-1431
Mailing address
311 GREEN ST, SYRACUSE, NY 13203-2911
(315) 425-1431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
203421-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01982172
—
NY
Enumeration date
07/27/2006
Last updated
04/28/2021
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