Healthcare Provider Details

I. General information

NPI: 1912417536
Provider Name (Legal Business Name): BODYMIND FLOAT CENTER SYRACUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2949 ERIE BLVD E STE 101
SYRACUSE NY
13224-1447
US

IV. Provider business mailing address

378 ROCKINGHAM ST
ROCHESTER NY
14620-2516
US

V. Phone/Fax

Practice location:
  • Phone: 315-992-8656
  • Fax:
Mailing address:
  • Phone: 585-797-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID BRICKMAN
Title or Position: MEMBER
Credential:
Phone: 585-797-3733