Individual
CIERRA ELIZABETH OMLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-8200
(315) 464-8206
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-8200
(315) 464-8206
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
026504
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2019
Last updated
11/18/2021
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