Mallory Conner, | |
739 Irving Ave Ste 340, Syracuse, NY 13210-1605 | |
(315) 479-5070 | |
Not Available |
Full Name | Mallory Conner |
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Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 739 Irving Ave Ste 340, Syracuse, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265030753 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 2020011129 (New York) | Primary |
Entity Name | Crouse Medical Practice Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922321934 PECOS PAC ID: 8426189622 Enrollment ID: O20100702000336 |
Mailing Address | Practice Location Address |
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Mallory Conner, 1001 W Fayette St Ste 400, Syracuse, NY 13204-2866 Ph: (315) 937-3433 | Mallory Conner, 739 Irving Ave Ste 340, Syracuse, NY 13210-1605 Ph: (315) 479-5070 |
Janice M Agen, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 90 Presidential Plz, 3rd Floor, Syracuse, NY 13202 Phone: 315-464-5210 Fax: 315-464-2141 | |
Irene S Borja, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 736 Irving Ave, Syracuse, NY 13210 Phone: 315-470-7111 | |
Mrs. Yingzi Wang, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 750 East Adams St, Syracuse, NY 13210 Phone: 315-464-1800 Fax: 315-464-6238 | |
Michele Rene Mcdonald, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 800 Irving Ave, Syracuse, NY 13210 Phone: 315-425-4400 | |
Nicole Marie Voudren, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 750 E Adams St, Syracuse, NY 13210 Phone: 315-254-6914 Fax: 315-464-8524 | |
Mary Jean Thomas, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 736 Irving Ave, Syracuse, NY 13210 Phone: 315-470-7111 | |
Frances I Swiecki, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 90 Presidential Plz, 5th Floor, Syracuse, NY 13202 Phone: 315-464-9335 Fax: 315-464-9338 |