Healthcare Provider Details

I. General information

NPI: 1841930492
Provider Name (Legal Business Name): DAVID BACH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 EAST ADAMS ST. 2ND FLOOR
SYRACUSE NY
13210
US

IV. Provider business mailing address

725 EAST ADAMS ST. 2ND FLOOR
SYRACUSE NY
13210
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-6100
  • Fax: 315-464-9246
Mailing address:
  • Phone: 315-464-6100
  • Fax: 315-464-9246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number344528
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: