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General NPI Number Information
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NPI Number | 1356697882
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Entity Type | Organization
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Legal Business Name | VILENSKY UPSTATE MEDICINE PC
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 135 SULLYS TRL STE 5
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City | PITTSFORD
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State | NY
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Zip | 14534-4564
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Country | US
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Telephone | 585-747-4226
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Fax | 855-783-4296
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Provider Business Mailing Address
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Address Line | PO BOX 2000
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-4500
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Country | US
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Telephone | 315-362-5129
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Fax | 315-362-5179
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Authorized Official
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Title or Position | OWNER
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Name | LEONID VILENSKY
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Credential | MD
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Telephone | 585-747-4226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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