MEDICARE: CENTRAL NEW YORK SERVICES, INC.

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	251B00000X	Case Management Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1437371317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL NEW YORK SERVICES, INC.

Provider Business Mailing Address
First Line	:	518 JAMES ST
Second Line	:	SUITE 240
City	:	SYRACUSE
State	:	NY
Zip	:	13203-2238
Country	:	US
Telephone Number	:	315-478-2453
Fax Number	:	315-425-8917

Provider Business Practice Location Address
First Line	:	518 JAMES ST
Second Line	:	SUITE 240
City	:	SYRACUSE
State	:	NY
Zip	:	13203-2238
Country	:	US
Telephone Number	:	315-478-2453
Fax Number	:	315-425-8917

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JOHN J WARREN
Credential	:	MSED
Telephone Number	:	315-478-2453

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	11/04/2008

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