Healthcare Provider Details

I. General information

NPI: 1659321859
Provider Name (Legal Business Name): FINGER LAKES HEMATOLOGY & ONCOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 AMBULANCE DRIVE
CLIFTON SPRINGS NY
14432
US

IV. Provider business mailing address

6 AMBULANCE DRIVE
CLIFTON SPRINGS NY
14432
US

V. Phone/Fax

Practice location:
  • Phone: 315-462-1472
  • Fax: 315-462-2639
Mailing address:
  • Phone: 315-462-1472
  • Fax: 315-462-2639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN M IGNACZAK
Title or Position: PHYSICIAN PARTNER
Credential: MD
Phone: 315-462-1472