Individual
ELIJAH DIING DUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
945 E GENESEE ST STE 200, SYRACUSE, NY 13210-1752
(315) 475-8401
Mailing address
110 EDTIM RD APT 4, SYRACUSE, NY 13206-2710
(135) 278-1367
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F337380-1
NY
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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