Healthcare Provider Details

I. General information

NPI: 1124190160
Provider Name (Legal Business Name): RESPIRATORY THERAPY RESOURCES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 FAY RD
SYRACUSE NY
13219-1612
US

IV. Provider business mailing address

326 FAY RD
SYRACUSE NY
13219-1612
US

V. Phone/Fax

Practice location:
  • Phone: 315-488-8087
  • Fax: 315-468-5488
Mailing address:
  • Phone: 315-488-8087
  • Fax: 315-468-5488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number003062-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MS. LORI A LEGERE
Title or Position: MANAGER MEMBER
Credential: RRT
Phone: 315-488-8087