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NPI Code Detail

MEDICARE: MAYA TERESA IGNASZEWSKI

MEDICARE: MAYA TERESA IGNASZEWSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1518376706
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA TERESA IGNASZEWSKI
Provider Business Mailing Address
First Line : 220 S WARREN ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13202-1676
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 750 E ADAMS ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-2306
Country : US
Telephone Number : 315-464-5540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2014
Last Update Date : 08/12/2014

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Directions to “ MAYA TERESA IGNASZEWSKI ” Practice Location

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