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NPI Code Detail

MEDICARE: ASSOCIATED HOSPITALISTS OF CROUSE LLC

MEDICARE: ASSOCIATED HOSPITALISTS OF CROUSE LLC
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
1208M00000XHospitalist PhysicianNANY

General Provider Information

NPI Number : 1962405241
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATED HOSPITALISTS OF CROUSE LLC
Provider Business Mailing Address
First Line : PO BOX 2004
Second Line :
City : EAST SYRACUSE
State : NY
Zip : 13057-4504
Country : US
Telephone Number : 315-449-2208
Fax Number : 315-362-5120
Provider Business Practice Location Address
First Line : 736 IRVING AVE
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-1687
Country : US
Telephone Number : 315-470-8837
Fax Number : 315-470-2961
Authorized Official
Title or Position : PRESIDENT
Name : JESSE WILLIAMS
Credential : MD
Telephone Number : 315-470-8837
Provider Enumeration Date : 05/31/2005
Last Update Date : 08/22/2020

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Directions to “ASSOCIATED HOSPITALISTS OF CROUSE LLC ” Practice Location

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