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General NPI Number Information
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NPI Number | 1447476254
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Entity Type | Organization
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Legal Business Name | MINIMALLY INVASIVE SURGERY OF OSWEGO COUNTY, PLLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 140 W 6TH ST SUITE 270
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City | OSWEGO
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State | NY
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Zip | 13126-2525
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Country | US
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Telephone | 315-342-3400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 196 140 WEST SIXTH STREET SUITE 270
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City | OSWEGO
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State | NY
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Zip | 13126-0196
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Country | US
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Telephone | 315-342-3400
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Fax |
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Authorized Official
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Title or Position | MINIMALLY INVASIVE SURGEON
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Name | DR. ALFRED AUGUSTINE SANTOS
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Credential | MD
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Telephone | 315-342-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 234085
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License Number State | NY
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