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General NPI Number Information
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NPI Number | 1548844798
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Entity Type | Organization
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Legal Business Name | JAMES C PREZZANO MD PLLC
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 212 HIGHBRIDGE ST STE A
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City | FAYETTEVILLE
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State | NY
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Zip | 13066-1981
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Country | US
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Telephone | 585-314-3290
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Fax |
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Provider Business Mailing Address
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Address Line | 4507 RED SPRUCE LN
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City | MANLIUS
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State | NY
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Zip | 13104-8313
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Country | US
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Telephone | 585-314-3290
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAMES C PREZZANO
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Credential | MD
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Telephone | 585-314-3290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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