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General NPI Number Information
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NPI Number | 1083702898
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Entity Type | Individual
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Provider Name | REBECCA N MCPHERSON O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 105 N MAIN ST
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City | NORTH SYRACUSE
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State | NY
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Zip | 13212-2324
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Country | US
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Telephone | 315-458-1000
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Fax | 315-458-1001
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Provider Business Mailing Address
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Address Line | 3439 VERPLANK RD
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City | CLAY
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State | NY
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Zip | 13041-9643
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Country | US
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Telephone | 315-695-2451
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | VUT005162
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License Number State | NY
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