MEDICARE: FORENSIC CONSULTANTS LTD

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	261Q00000X	Clinic/Center	161110789	NY

General Provider Information

NPI Number	:	1922275270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORENSIC CONSULTANTS LTD

Provider Business Mailing Address
First Line	:	2112 ERIE BLVD E
Second Line	:	SUITE 200
City	:	SYRACUSE
State	:	NY
Zip	:	13224-1041
Country	:	US
Telephone Number	:	315-472-1212
Fax Number	:

Provider Business Practice Location Address
First Line	:	2112 ERIE BLVD E
Second Line	:	SUITE 200
City	:	SYRACUSE
State	:	NY
Zip	:	13224-1041
Country	:	US
Telephone Number	:	315-472-1212
Fax Number	:	315-472-1418

Authorized Official
Title or Position	:	PROVIDER
Name	:	MR. MICHAEL A MONTGOMERY
Credential	:	RN
Telephone Number	:	315-472-1212

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	02/01/2017

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