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NPI Code Detail

MEDICARE: SYRACUSE HOME ASSOCIATION

MEDICARE: SYRACUSE HOME ASSOCIATION
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
1314000000XSkilled Nursing Facility3327301NNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396742482
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYRACUSE HOME ASSOCIATION
Provider Business Mailing Address
First Line : 7740 MEIGS RD
Second Line :
City : BALDWINSVILLE
State : NY
Zip : 13027-9757
Country : US
Telephone Number : 315-638-2521
Fax Number : 315-638-2552
Provider Business Practice Location Address
First Line : 7740 MEIGS RD
Second Line :
City : BALDWINSVILLE
State : NY
Zip : 13027-9757
Country : US
Telephone Number : 315-638-2521
Fax Number : 315-638-2552
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. MARK MURPHY
Credential :
Telephone Number : 315-638-2521
Provider Enumeration Date : 07/05/2005
Last Update Date : 06/12/2015

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1417590803 — MRS. SHARI MCGILL PTA
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Directions to “SYRACUSE HOME ASSOCIATION ” Practice Location

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