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General NPI Number Information
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NPI Number | 1285138602
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Entity Type | Individual
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Provider Name | EVE PRIVMAN CHAMPALOUX MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 750 EAST ADAM ST CWB ROOM 241
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City | SYRACUSE
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State | NY
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Zip | 13210-2306
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Country | US
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Telephone | 315-464-4636
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Fax | 315-464-7282
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Provider Business Mailing Address
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Address Line | 750 EAST ADAM ST CWB ROOM 241
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City | SYRACUSE
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State | NY
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Zip | 13210-2306
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Country | US
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Telephone | 315-464-4636
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Fax | 315-464-7282
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD61544550
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | MD61544550
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 337019
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License Number State | NY
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