Provider Demographics
NPI:1407339096
Name:LETOURNEAU, AUBREY LYNN (NP)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:LYNN
Last Name:LETOURNEAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4939 BRITTONFIELD PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9208
Mailing Address - Country:US
Mailing Address - Phone:315-634-6779
Mailing Address - Fax:315-634-6789
Practice Address - Street 1:4939 BRITTONFIELD PKWY STE 101
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9208
Practice Address - Country:US
Practice Address - Phone:315-634-6779
Practice Address - Fax:315-634-6789
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343531207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine