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General NPI Number Information
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NPI Number | 1629231204
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Entity Type | Organization
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Legal Business Name | CYTOLOGY ASSOCIATES OF CNY PLLC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 11/26/2008
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Provider Practice Location Address
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Address Line | 736 IRVING AVE 9TH FL - PATHOLOGY
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City | SYRACUSE
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State | NY
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Zip | 13210-1687
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Country | US
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Telephone | 315-470-7396
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Fax |
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Provider Business Mailing Address
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Address Line | 4567 CROSSROADS PARK DR
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City | LIVERPOOL
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State | NY
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Zip | 13088-3589
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Country | US
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Telephone | 315-295-2100
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | TERIZA SHEHATOU
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Credential | MD
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Telephone | 315-470-7396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 236767
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License Number State | NY
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