Healthcare Provider Details

I. General information

NPI: 1588707459
Provider Name (Legal Business Name): CHRISTINE ARIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PROSPECT AVE NICU
SYRACUSE NY
13203-1807
US

IV. Provider business mailing address

104 UNION AVE SUITE 804
SYRACUSE NY
13203-1843
US

V. Phone/Fax

Practice location:
  • Phone: 315-448-5111
  • Fax: 315-703-5079
Mailing address:
  • Phone: 315-703-5049
  • Fax: 315-703-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number310910
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: