Lisa Marie Polhamus NNP

NPI 1114188604 - Nurse Practitioner - 363LN0000X

NPI Details
NPI 1114188604
Gender Female
Enumeration Date 06/18/2008
Last Updated 05/18/2009
Entity Type Individual
Active Over 8 years ago
Practice Location
736 IRVING AVE
SUITE 9100
SYRACUSE NY, 13210-1687, US
Phone (315) 470-7379
Fax (315) 470-2923
Business Location
736 IRVING AVE
SUITE 9100
SYRACUSE NY, 13210-1687, US
Phone (315) 470-7379
Fax (315) 470-2923
Toxanomy
Taxonomy Code 363LN0000X
License State New York
License Number 350289
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According to our database, Ms. Lisa Marie Polhamus NNP NPI is 1114188604, taxonomy code is 363LN0000X and license number is 350289, license state is located at New York. Lisa Marie Polhamus NNP physically located at 736 Irving Ave, Syracuse NY, 13210-1687. NPI Number Lisa Marie Polhamus NNP has the Individual type.

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1114188604 NPI number is provided on an as is basis without warranty of any kind. 1114188604 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Marie Polhamus NNP are for informational purposes only.