Healthcare Provider Details

I. General information

NPI: 1194837526
Provider Name (Legal Business Name): GAIL MCCUE DONNERY NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E GENESEE ST STE 403 HILL MEDICAL CENTER
SYRACUSE NY
13210-1840
US

IV. Provider business mailing address

1000 E GENESEE ST STE 403 HILL MEDICAL CENTER
SYRACUSE NY
13210-1840
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-2929
  • Fax: 315-464-2930
Mailing address:
  • Phone: 315-464-2929
  • Fax: 315-464-2930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number301616
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: