Provider Demographics
NPI:1740394683
Name:DEFURIA, MARY GAY (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:GAY
Last Name:DEFURIA
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Gender:F
Credentials:NP
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Mailing Address - Street 1:945 E GENESEE ST STE 200
Mailing Address - Street 2:PULMONARY HEALTH PHYSICIANS
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1752
Mailing Address - Country:US
Mailing Address - Phone:315-475-8401
Mailing Address - Fax:315-475-0824
Practice Address - Street 1:945 E GENESEE ST STE 200
Practice Address - Street 2:PULMONARY HEALTH PHYSICIANS
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1752
Practice Address - Country:US
Practice Address - Phone:315-475-8401
Practice Address - Fax:315-475-0824
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NYF303041363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health