Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 283795 | NY |
Y | 2080P0204X | Pediatric Emergency Doctor | 283795 | NY |
NPI | 1316367220 |
---|---|
Provider Name | Vincent J. Calleo |
First Address | Syracuse, NY 13212-4516 |
Second Address | Syracuse, NY 13210-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2014 |
Last Update Date | 24/11/2021 |