MEDICARE: JOHN J POGGI MD

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	207RH0003X	Hematology & Oncology Physician	121002	NY

General Provider Information

NPI Number	:	1205821196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN J POGGI MD

Provider Business Mailing Address
First Line	:	PO BOX 2002
Second Line	:
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-4502
Country	:	US
Telephone Number	:	315-449-2208
Fax Number	:	315-362-5120

Provider Business Practice Location Address
First Line	:	531 WASHINGTON ST
Second Line	:
City	:	WATERTOWN
State	:	NY
Zip	:	13601-4084
Country	:	US
Telephone Number	:	315-788-7990
Fax Number	:	315-788-4248

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	04/24/2009

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