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General NPI Number Information
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NPI Number | 1083160295
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Entity Type | Individual
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Provider Name | CAMERON DELMOTTE
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Gender | Male
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 159 WEST FRIST STREET
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City | OSWEGO
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State | NY
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Zip | 13126
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Country | US
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Telephone | 315-342-9575
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Fax |
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Provider Business Mailing Address
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Address Line | 5548 BEAR RD APT 6F
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City | NORTH SYRACUSE
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State | NY
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Zip | 13212-1429
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Country | US
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Telephone | 315-412-1908
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2707242
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License Number State | NY
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