Most Relevant Information
Provider Data
| NPI Number: | 1003343237 |
| Provider Name: | AUDREY VICTORIA VANDEWALL DO |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | 5101025536 |
Most Important Dates
| Enumeration Date: | 05/18/2017 |
| Last Updated: | 10/10/2022 |
Provider Practice Location
750 E ADAMS ST
SYRACUSE
NY
132102306
Practice Location Phone/Fax
| Phone: | 3154085854 |
| Fax: |
Provider Mailing Location
750 E ADAMS ST
SYRACUSE
NY
132102306
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |
Suggested EMR
Pediatrics EMR