Healthcare Provider Details

I. General information

NPI: 1417216219
Provider Name (Legal Business Name): MS. KERRY ELIZABETH WHITING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 E WATER ST
SYRACUSE NY
13210-1155
US

IV. Provider business mailing address

8700 SHEPHERD RD
WEEDSPORT NY
13166-3180
US

V. Phone/Fax

Practice location:
  • Phone: 315-478-4185
  • Fax: 315-478-0840
Mailing address:
  • Phone: 315-834-8964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SM0001X
TaxonomyMolecular Genetic Pathology (Medical Genetics) Physician
License Number281301
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number281301
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number281301
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: