Individual
THOMAS W VANARNAM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5719 WIDEWATERS PKWY, SYRACUSE, NY 13214-1985
(315) 251-3100
(315) 449-9923
Mailing address
5719 WIDEWATERS PKWY, SYRACUSE, NY 13214-1985
(315) 251-3100
(315) 449-9923
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012128
NY
363AS0400X
Surgical Physician Assistant
012128
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03340181
—
NY
Enumeration date
10/11/2007
Last updated
10/20/2011
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