Provider Demographics
NPI:1639851678
Name:LOGAN, ARLEE J (NP)
Entity Type:Individual
Prefix:MR
First Name:ARLEE
Middle Name:J
Last Name:LOGAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:251 SALINA MEADOWS PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212
Mailing Address - Country:US
Mailing Address - Phone:315-464-2000
Mailing Address - Fax:315-464-2010
Practice Address - Street 1:750 EAST ADAMS STREET
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2306
Practice Address - Country:US
Practice Address - Phone:315-464-5910
Practice Address - Fax:315-464-4761
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY325008363L00000X, 363LF0000X
NY352008207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily