Individual
TRAVIS T. CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4900 BROAD RD, SYRACUSE, NY 13215-2265
(315) 492-5522
Mailing address
PO BOX 2005, EAST SYRACUSE, NY 13057-4505
(315) 362-5129
(315) 362-5179
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
610592
NY
Other
Enumeration date
03/17/2009
Last updated
03/17/2009
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