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General NPI Number Information
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NPI Number | 1073587416
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Entity Type | Organization
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Legal Business Name | SYRACUSE ENDOSCOPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 5000 CAMPUSWOOD DRIVE SUITE 100
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City | EAST SYRACUSE
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State | NY
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Zip | 13057
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Country | US
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Telephone | 315-234-6688
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Fax | 315-234-6689
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Provider Business Mailing Address
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Address Line | 5000 CAMPUSWOOD DRIVE SUITE 100
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City | EAST SYRACUSE
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State | NY
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Zip | 13057
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Country | US
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Telephone | 315-234-6688
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Fax | 315-234-6689
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KATHLEEN M KENDRICK
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Credential | RN, MBA, MSN
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Telephone | 315-234-6687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number | 3301219
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License Number State | NY
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