Doctor Name: | MRS. JANICE MOREY PEDERSEN |
NPI Number: | 1013019264 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | F301403 |
Business Practice Address: | 800 Irving Ave A 447 Syracuse, NY - 132102716 |
Business Phone Number: | 3154254400 |
Business Fax Number: | 3154252681 |
Mailing Address: | 800 Irving Ave, A 447 SYRACUSE |
State: | NY |
Postal Code: | 132102716 |
Phone Number: | 3154254400 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F301403 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |