1295878130 NPI number — HEMATOLOGY-ONCOLOGY ASSOCIATES OF CNY, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295878130 NPI number — HEMATOLOGY-ONCOLOGY ASSOCIATES OF CNY, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMATOLOGY-ONCOLOGY ASSOCIATES OF CNY, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295878130
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5008 BRITTONFIELD PKWY
Provider Second Line Business Mailing Address:
SUITE 700
Provider Business Mailing Address City Name:
EAST SYRACUSE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13057-9248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-472-7504
Provider Business Mailing Address Fax Number:
315-479-8639

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5700 W GENESEE ST
Provider Second Line Business Practice Location Address:
SUITE 10 SOUTH
Provider Business Practice Location Address City Name:
CAMILLUS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13031-3200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-472-7504
Provider Business Practice Location Address Fax Number:
315-479-8639
Provider Enumeration Date:
02/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NOTARO
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CONTRACT ANALYST
Authorized Official Telephone Number:
315-472-7504

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)