Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 137793-1 | NY |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 137793-1 | NY |
NPI | 1033129721 |
---|---|
Provider Name | Pamela Sue Horst |
First Address | Syracuse, NY 13203 |
Second Address | Syracuse, NY 13203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 19/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00832393 | (05) | NY |
B82338 | (02) |