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NPI Code Detail

MEDICARE: SYRACUSE ORTHOPEDIC SPECIALISTS, PC

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 License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1669410379
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 : 315-449-9923
Provider Business Practice Location Address
First Line : 5719 WIDEWATERS PARKWAY
Second Line :
City : SYRACUSE
State : NY
Zip : 13214-1880
Country : US
Telephone Number : 315-251-3100
Fax Number : 315-552-6018
Authorized Official
Title or Position : PRESIDENT
Name : BRETT GREENKY III
Credential : MD
Telephone Number : 315-251-3100
Provider Enumeration Date : 06/03/2006
Last Update Date : 06/24/2021

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