Healthcare Provider Details

I. General information

NPI: 1003294265
Provider Name (Legal Business Name): ALWIN HEUER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 E TAFT RD
SYRACUSE NY
13212-3291
US

IV. Provider business mailing address

300 LONG SHOALS RD APT 7J
ARDEN NC
28704-7720
US

V. Phone/Fax

Practice location:
  • Phone: 315-418-4140
  • Fax:
Mailing address:
  • Phone: 205-705-4425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number695210
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number077829-23
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number695210
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: