MEDICARE: SYNAPSE THERAPEUTICS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1225026594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNAPSE THERAPEUTICS INC

Provider Business Mailing Address
First Line	:	501 WESTERN AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-2870
Country	:	US
Telephone Number	:	818-242-5887
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 WESTERN AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-2870
Country	:	US
Telephone Number	:	818-242-5887
Fax Number	:	818-507-6324

Authorized Official
Title or Position	:	CEO/SEC/CFO/DIR/PRESIDENT
Name	:	ARTHUR AVETISYAN
Credential	:
Telephone Number	:	818-242-5887

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	10/10/2023

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