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NPI Code Detail

MEDICARE: NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES PC

MEDICARE: NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES PC
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
1332B00000XDurable Medical Equipment & Medical Supplies
2208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1841285996
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES PC
Provider Business Mailing Address
First Line : PO BOX 510
Second Line :
City : SYRACUSE
State : NY
Zip : 13214-0510
Country : US
Telephone Number : 315-703-3484
Fax Number : 315-703-3487
Provider Business Practice Location Address
First Line : 5496 E TAFT RD
Second Line :
City : NORTH SYRACUSE
State : NY
Zip : 13212-3784
Country : US
Telephone Number : 315-552-6700
Fax Number : 315-552-6701
Authorized Official
Title or Position : PRESIDENT
Name : ROBERT L TISO
Credential : MD
Telephone Number : 315-552-6700
Provider Enumeration Date : 09/14/2005
Last Update Date : 02/25/2014

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