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NPI Code Detail

MEDICARE: JAMIE KAYE BACH MSN, SCRN, ACNPC-AG

MEDICARE: JAMIE KAYE BACH MSN, SCRN, ACNPC-AG
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
1363LA2100XAcute Care Nurse PractitionerF312614NY
2363LA2200XAdult Health Nurse PractitionerF312614NY
3363LG0600XGerontology Nurse PractitionerF312614NY
4208M00000XHospitalist PhysicianF312614NY

General Provider Information

NPI Number : 1881557569
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE KAYE BACH MSN, SCRN, ACNPC-AG
Provider Business Mailing Address
First Line : 4900 BROAD RD
Second Line :
City : SYRACUSE
State : NY
Zip : 13215-2265
Country : US
Telephone Number : 402-960-1970
Fax Number :
Provider Business Practice Location Address
First Line : 4900 BROAD RD
Second Line :
City : SYRACUSE
State : NY
Zip : 13215-2265
Country : US
Telephone Number : 315-492-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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