Provider Demographics
NPI:1720630064
Name:PUDNEY, JACEY M (MD)
Entity type:Individual
Prefix:DR
First Name:JACEY
Middle Name:M
Last Name:PUDNEY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:725 E ADAMS STREET
Mailing Address - Street 2:2ND FL
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-6100
Mailing Address - Fax:315-464-9246
Practice Address - Street 1:725 E ADAMS STREET
Practice Address - Street 2:2ND FL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-6100
Practice Address - Fax:315-464-9246
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2023-10-27
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Provider Licenses
StateLicense IDTaxonomies
NY318719207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine