Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 309007 | NY |
N | 207VX0000X | Obstetrician | 309007 | NY |
NPI | 1013400753 |
---|---|
Provider Name | Omazonna Amadi |
First Address | Syracuse, NY 13203-1807 |
Second Address | Syracuse, NY 13203-1899 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2018 |
Last Update Date | 23/09/2021 |