Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 036143309 | IL |
Y | 2086S0102X | Surgical Critical Care | 306911 | NY |
NPI | 1114990348 |
---|---|
Provider Name | Dr. Kimberly Marie Syres |
First Address | Rochester, NY 14617-5504 |
Second Address | Rochester, NY 14621-3022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 01/10/2020 |