Jerry T Roy
Registered Nurse, Psych/Mental Health, Adult in Syracuse, NY. Individual provider (NPI-1).
NPI number1891512331
StatusActive
Last updated in NPPESSep 25, 2024
Details
- NPI
- 1891512331
- Entity type
- Individual (NPI-1)
- Name
- Jerry T Roy
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 25, 2024
- Certification date
- Sep 25, 2024
- Last updated
- Sep 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | 836464 | NY | Yes |
Practice location
620 Madison StSyracuse, NY 13210-2319
Phone 315-426-3600
Mailing address
101 Westholm BlvdSyracuse, NY 13219-2914
Phone 315-418-0672
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