Cory Brocious
Case Manager/Care Coordinator in Syracuse, NY. Individual provider (NPI-1).
NPI number1134519804
StatusActive
Last updated in NPPESFeb 2, 2015
Details
- NPI
- 1134519804
- Entity type
- Individual (NPI-1)
- Name
- Cory Brocious
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 2, 2015
- Last updated
- Feb 2, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
813 Fay RdSyracuse, NY 13219-3009
Phone 315-703-0810 · Fax 315-703-0814
Mailing address
127 Campbell RdMattydale, NY 13211-1203
Phone 315-703-0810 · Fax 315-703-0814
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