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NPI Code Detail

MEDICARE: DR. ENRIQUE JAVIER ARMENTA MD

MEDICARE: DR. ENRIQUE JAVIER ARMENTA 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
1174400000XSpecialist1307628NY
2208200000XPlastic Surgery Physician130762-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1160984946OTHERNYPLASTIC SURGRY

General Provider Information

NPI Number : 1225111917
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ENRIQUE JAVIER ARMENTA MD
Provider Business Mailing Address
First Line : 2200 E GENESEE ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-2298
Country : US
Telephone Number : 315-476-7459
Fax Number : 315-471-4036
Provider Business Practice Location Address
First Line : 3107 E GENESEE ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13224-1646
Country : US
Telephone Number : 315-299-5313
Fax Number : 315-299-5661
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 03/30/2020

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