Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 145925 | NY |
NPI | 1215086350 |
---|---|
Provider Name | Dr. Craig J Byrum |
First Address | Syracuse, NY 13210-1603 |
Second Address | Syracuse, NY 13210-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 26/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00630800 | (05) | NY |
C59406 | (02) | NY |