Doctor Name: | JACLYN KORVER |
NPI Number: | 1003239047 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 668191 |
Business Practice Address: | 108 Shonnard St Syracuse, NY - 132043216 |
Business Phone Number: | 3154354973 |
Business Fax Number: | |
Mailing Address: | 5088 Lincklaen Rd, CAZENOVIA |
State: | NY |
Postal Code: | 130359749 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/28/2014 |
NPI Last Update Date: | 01/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0200X |
License Number: | 668191 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |