MEDICARE: DR. KATSUHIRO KOBAYASHI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	268265	NY
2	174400000X	Specialist	01063987A	IN

General Provider Information

NPI Number	:	1194916866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATSUHIRO KOBAYASHI M.D.

Provider Business Mailing Address
First Line	:	750 E ADAMS ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13210-1834
Country	:	US
Telephone Number	:	315-464-7439
Fax Number	:	315-464-8789

Provider Business Practice Location Address
First Line	:	750 E ADAMS ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13210-1834
Country	:	US
Telephone Number	:	315-464-7439
Fax Number	:	315-464-8789

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	05/31/2022

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