Healthcare Provider Details

I. General information

NPI: 1508058355
Provider Name (Legal Business Name): HUTCHINGS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 MADISON ST
SYRACUSE NY
13210-2319
US

IV. Provider business mailing address

44 HOLLAND AVE
ALBANY NY
12229-0001
US

V. Phone/Fax

Practice location:
  • Phone: 315-473-4980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: ROBERT PUCCIO
Title or Position: DIRECTOR, FINANCE
Credential:
Phone: 518-473-0795