ST JOSEPH'S MEDICAL PC NPI 1609237304

NPI Information

NPI: 1609237304
Provider Name: ST JOSEPH'S MEDICAL PC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
104 UNION AVE
STE 1005
SYRACUSE, NY
ZIP 13203
Phone: (315) 424-0790
Get Directions

ST JOSEPH'S MEDICAL PC is a vascular surgery surgery in Syracuse, NY. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. ST JOSEPH'S MEDICAL PC NPI is 1609237304. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

104 UNION AVE
STE 1005
SYRACUSE, NY
ZIP 13203-843
Phone: (315) 424-0790
Fax: (315) 475-0916

The provider's authorized official is Sandra M Sulik .
The authorized official title is President and has the following contact phone number (315) 744-1865.

The enumeration date for this NPI number is 3/9/2016 and was last updated on 3/9/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	03370858	MEDICAID	NEW YORK
2	J100036677	MEDICARE PIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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