Provider Demographics
NPI:1104686302
Name:LARMER, CHAD D (CRPA - NYCPS)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:D
Last Name:LARMER
Suffix:
Gender:M
Credentials:CRPA - NYCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1709
Mailing Address - Country:US
Mailing Address - Phone:315-478-2968
Mailing Address - Fax:
Practice Address - Street 1:610 N STATE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1709
Practice Address - Country:US
Practice Address - Phone:315-478-2968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCRPA-5336175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist