MEDICARE: SYRACUSE ORTHOPEDIC SPECIALISTS, PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	225100000X	Physical Therapist
3	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1376963645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYRACUSE ORTHOPEDIC SPECIALISTS, PC

Provider Business Mailing Address
First Line	:	5824 WIDEWATERS PKWY
Second Line	:
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-3072
Country	:	US
Telephone Number	:	315-251-3105
Fax Number	:

Provider Business Practice Location Address
First Line	:	4994 W SENECA TPKE
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13215-2279
Country	:	US
Telephone Number	:	315-469-5990
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SETH GREENKY
Credential	:	MD
Telephone Number	:	315-251-3100

Provider Enumeration Date	:	04/24/2014
Last Update Date	:	04/13/2020

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