Healthcare Provider Details

I. General information

NPI: 1184652117
Provider Name (Legal Business Name): HOM P NEUPANE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 PRESIDENTIAL PLZ
SYRACUSE NY
13202-2240
US

IV. Provider business mailing address

90 PRESIDENTIAL PLZ
SYRACUSE NY
13202-2240
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-3836
  • Fax: 315-464-3837
Mailing address:
  • Phone: 315-464-3836
  • Fax: 315-464-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number002342
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: