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General NPI Number Information
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NPI Number | 1407072465
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Entity Type | Organization
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Legal Business Name | SYRACUSE UNIVERSITY HOSPITAL
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 116 BAILEY DR
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City | NEDROW
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State | NY
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Zip | 13120-1202
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Country | US
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Telephone | 315-498-9272
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Fax |
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Provider Business Mailing Address
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Address Line | 116 BAILEY DR
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City | NEDROW
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State | NY
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Zip | 13120-1202
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Country | US
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Telephone | 315-498-9272
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Fax |
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Authorized Official
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Title or Position | STAFF RN
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Name | MRS. SUSAN MARIE DEAN
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Credential |
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Telephone | 315-857-4521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number |
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License Number State |
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