MEDICARE: JAMES E EDINGER MD

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	207Q00000X	Family Medicine Physician	182686	NY

General Provider Information

NPI Number	:	1457339756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES E EDINGER MD

Provider Business Mailing Address
First Line	:	1001 W FAYETTE ST
Second Line	:	STE 400
City	:	SYRACUSE
State	:	NY
Zip	:	13204-2859
Country	:	US
Telephone Number	:	315-472-1488
Fax Number	:	315-472-8060

Provider Business Practice Location Address
First Line	:	57 STATE ST
Second Line	:
City	:	TULLY
State	:	NY
Zip	:	13159-3218
Country	:	US
Telephone Number	:	315-696-4635
Fax Number	:	315-696-6108

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	05/12/2008

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Directions to “ JAMES E EDINGER MD” Practice Location

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