Provider Demographics
NPI:1568592947
Name:PLEWES, GARFIELD DAVID
Entity Type:Individual
Prefix:
First Name:GARFIELD
Middle Name:DAVID
Last Name:PLEWES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 OAKLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-3108
Mailing Address - Country:US
Mailing Address - Phone:315-458-3094
Mailing Address - Fax:
Practice Address - Street 1:118 OAKLEY DR
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-3108
Practice Address - Country:US
Practice Address - Phone:315-458-3094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381483-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02801307Medicaid