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General NPI Number Information
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NPI Number | 1922275270
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Entity Type | Organization
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Legal Business Name | FORENSIC CONSULTANTS LTD
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 2112 ERIE BLVD E SUITE 200
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City | SYRACUSE
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State | NY
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Zip | 13224-1041
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Country | US
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Telephone | 315-472-1212
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Fax | 315-472-1418
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Provider Business Mailing Address
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Address Line | 2112 ERIE BLVD E SUITE 200
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City | SYRACUSE
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State | NY
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Zip | 13224-1041
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Country | US
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Telephone | 315-472-1212
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MR. MICHAEL A MONTGOMERY
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Credential | RN
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Telephone | 315-472-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 161110789
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License Number State | NY
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