FAIRGROUNDS FAMILY PHYSICIANS PLLC NPI 1174690440

NPI Information

  • NPI: 1174690440
  • Provider Name: FAIRGROUNDS FAMILY PHYSICIANS PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 33D0682921
  • Address: 115 FAIRGROUNDS DRIVE
    MANLIUS, NY
    ZIP 13104
  • Phone: (315) 682-6165

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NPI Details

FAIRGROUNDS FAMILY PHYSICIANS PLLC is a family medicine in Manlius, NY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAIRGROUNDS FAMILY PHYSICIANS PLLC NPI is 1174690440. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

115 FAIRGROUNDS DRIVE
MANLIUS, NY
ZIP 13104
Phone: (315) 682-6165
Fax: (615) 682-7929

The provider's authorized official is Philip Kaplan .
The authorized official title is Member and has the following contact phone number (315) 682-6165.

The CLIA number assigned to this NPI record is 33D0682921 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 1/9/2025.

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
1207Q00000XFamily MedicineYes

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: 11/21/2025

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