Provider Demographics
NPI:1760613483
Name:CROSS, WILLIAM MCEWAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MCEWAN
Last Name:CROSS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4673 WHETSTONE RD
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-2516
Mailing Address - Country:US
Mailing Address - Phone:315-474-3762
Mailing Address - Fax:
Practice Address - Street 1:120 E WASHINGTON ST
Practice Address - Street 2:SUITE 924
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-4000
Practice Address - Country:US
Practice Address - Phone:315-474-3762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000338106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist