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Individual

J KURT CONCILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3229 E GENESEE ST, JOSLIN CENTER, SYRACUSE, NY 13214-2016
(315) 464-5726
(315) 464-2500
Mailing address
3229 E GENESEE ST, JOSLIN CENTER, SYRACUSE, NY 13214-2016
(315) 464-5726
(315) 464-2500

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003073
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01704741
NY
Enumeration date
12/21/2005
Last updated
02/04/2014
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