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1427299197
STACEY B WALL
SYRACUSE, NY
NPI
1427299197
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY F300896)
Enumeration Date
2009-03-10
Last Update Date
2012-01-11
Business Address
-- STACEY B WALL N.P.
945 E GENESEE ST SUITE 200
SYRACUSE, NY 13210-1752
Phone number: 315-475-8401
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Mailing Address
-- STACEY B WALL N.P.
945 E GENESEE ST SUITE 200
SYRACUSE, NY 13210-1752
Phone number: 315-475-8401
Copy
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