Healthcare Provider Details

I. General information

NPI: 1700109956
Provider Name (Legal Business Name): ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 10/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 N JAMES ST SUITE 900
ROME NY
13440-2852
US

IV. Provider business mailing address

1226 E WATER ST
SYRACUSE NY
13210-1155
US

V. Phone/Fax

Practice location:
  • Phone: 315-336-0499
  • Fax:
Mailing address:
  • Phone: 315-478-4185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: HOWARD WILLIAMS
Title or Position: PRESIDENT
Credential: MD
Phone: 315-478-4185