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General NPI Number Information
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NPI Number | 1700689353
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Entity Type | Individual
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Provider Name | PUNEET MISRA MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2025
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Last Update Date | 08/17/2025
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Provider Practice Location Address
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Address Line | 620 MADISON ST
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City | SYRACUSE
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State | NY
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Zip | 13210-2319
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Country | US
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Telephone | 315-426-3647
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Fax |
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Provider Business Mailing Address
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Address Line | 606 MOUNTAIN RD
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City | KINNELON
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State | NJ
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Zip | 07405-2129
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Country | US
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Telephone | 585-485-3416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 335592
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 335592
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License Number State | NY
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