SUNY UPSTATE (NPI# 1053789610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053789610 |
Entity Type | Organization |
Organization Name | SUNY UPSTATE |
Practice Address |
90 Presidential Plz Syracuse NY 13202-2240 |
Mailing Address |
5104 Waterford Wood Way Fayetteville NY 13066-9799 |
Practice Telephone | 3154643833 |
Mailing Telephone | 6077597462 |
Enumeration Date | 2015-09-11 |
Last Update Date | 2015-09-11 |
Authorized Official Name | MRS. VIKTORIA KENNEY (FNP) |
Authorized Official Telephone | 6077597462 |
Authorized Official Credential | FNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | F339820-1 | NY | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649530775 | Suny Upstate | General Acute Care Hospital | 215 Bassett St, Syracuse, NY 13210-2113 | 2012-05-23 |
1952551897 | Suny Upstate | General Acute Care Hospital | 750 East Adams St, Syracuse, NY 13210 | 2008-09-29 |
Street Address |
90 PRESIDENTIAL PLZ |
City | SYRACUSE |
State | NY |
Zip Code | 13202-2240 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992702278 | Michael P Sharak | Physician Assistant | 90 Presidential Plz, Firm B, Syracuse, NY 13202-2240 | 2005-07-01 |
1558978940 | Krista Marie Shanholtz | Family Medicine | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2020-09-29 |
1689299505 | Kimberly Ann Cerasani | Nurse Practitioner | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2020-06-16 |
1235609512 | Sara Marie Obrist | Social Worker | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2018-11-29 |
1063949816 | Catherine Bird Fessenden | Student in an Organized Health Care Education/Training Program | 90 Presidential Plz, Suite 300, Syracuse, NY 13202-2240 | 2017-05-11 |
1013469873 | Davia Gaelin Moss | Registered Nurse | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2016-10-27 |
1285183335 | Stacy Jo Mcclintic | Dietitian, Registered | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2016-09-30 |
1235590738 | Lara Kratochwill | Pharmacist | 90 Presidential Plz, Adult Medicine Clinic, Syracuse, NY 13202-2240 | 2016-03-10 |
1699144527 | Viktoria Kenney | Nurse Practitioner | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2015-09-22 |
1053727503 | Hassan Mahdi Al-khalisy | Student in an Organized Health Care Education/Training Program | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2014-07-05 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255804456 | Lisa Blachford | Registered Nurse | 421 Montgomery St Room 80, Syracuse, NY 13202 | 2019-01-10 |
1851873640 | Syracuse Community Health Center, Inc. | Case Management | 819 South Salina Street, Syracuse, NY 13202 | 2018-08-29 |
1245739713 | Telibra Lloyd | Counselor | 375 W Onondaga St Suite 10, Syracuse, NY 13202 | 2018-02-09 |
1326574534 | Wendell Covell | Social Worker | 50 Presidential Plaza, Jefferson Tower Suite Ll05, Syracuse, NY 13202 | 2017-05-08 |
1083165005 | Candy Herbert | Counselor | 375 W. Onondaga St. Suite 10, Syracuse, NY 13202 | 2016-10-14 |
1427429760 | Joshua Caryl | Counselor | 319 East Water Street, Syracuse, NY 13202 | 2015-10-13 |
1093140956 | Jennifer B Mccaffrey | Nurse Practitioner | 421 Montgomery Street Room 80, Onondaga County Health Dept. Bureau of Disease Control, Syracuse, NY 13202 | 2013-09-11 |
1336581552 | Emily Renee Haggerty | Hospitalist | 500 Harrison St, 1705a, Syracuse, NY 13202 | 2013-07-30 |
1134470933 | Tanya Marie Harlec Mcguire | Genetic Counselor, MS | 90 Presdential Plaza Uhcc 3rd Fl., Regional Perinatal Center Suny Upstate Medical Ctr, Syracuse, NY 13202 | 2012-09-20 |
1104176320 | Mary Jo Maestri | Genetic Counselor, MS | 90 Presidential Plaza Uhcc- Perinatal Ceter, University Hospital/upstate Medical Center, Syracuse, NY 13202 | 2012-09-14 |
Find all providers in zip 13202 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912417536 | Bodymind Float Center Syracuse LLC | Clinic/Center | 2949 Erie Blvd E Ste 101, Syracuse, NY 13224-1447 | 2017-10-10 |
1922275270 | Forensic Consultants Ltd | Clinic/Center | 2112 Erie Blvd E, Suite 200, Syracuse, NY 13224-1041 | 2008-05-14 |
1558914796 | Thrive Therapy LLC | Clinic/Center | 918 James St, Syracuse, NY 13203-2500 | 2019-07-17 |
1699063776 | Schc Prenatal/pediatric Li Mr | Clinic/Center | 819 S Salina St, Syracuse, NY 13202-3527 | 2011-07-11 |
1215244223 | Susan Macmillan Rioux | Clinic/Center | 736 Irving Ave, Educational Services Dept, Syracuse, NY 13210-1687 | 2010-09-13 |
1356505531 | Michelle J Arrindell | Clinic/Center | 324 University Ave, Syracuse, NY 13210-1811 | 2008-07-16 |
1548366271 | Loretto Rest Realty Corporation | Clinic/Center | 700 E Brighton Ave, Syracuse, NY 13205-2201 | 2006-09-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356942411 | Medical Offices of Occupational Health Resources P C | Clinic/Center | 240 Airport Rd, White Plains, NY 10604-1315 | 2020-11-05 |
1649884537 | Bridge To Care Nurse Practitioner In Psychiatry PC | Clinic/Center | 3005 Church Ave, Brooklyn, NY 11226-4209 | 2020-09-08 |
1093328890 | Philomene Goueliani Phd | Clinic/Center | 1461 E 103rd St, Brooklyn, NY 11236-4513 | 2020-08-31 |
1801409792 | Lori Davis, Np In Family Health Pllc | Clinic/Center | 317 N Aurora St Ste 200a, Ithaca, NY 14850-4201 | 2020-08-28 |
1679190326 | Payless Staffing and Consultants | Clinic/Center | 1332 Commerce Ave Frnt 3, Bronx, NY 10461-3612 | 2020-06-29 |
1487279238 | Nss Medical Services, Pllc | Clinic/Center | 322 Linden Blvd., Ground Floor, Brooklyn, NY 11226 | 2020-06-08 |
1275157000 | Provident Health Partners Inc. | Clinic/Center | 1529 N Ocean Ave Ste A, Medford, NY 11763-3587 | 2020-06-08 |
1922635218 | Proficient Rehab Care Pt Pllc | Clinic/Center | 121 Winham Ave, Staten Island, NY 10306-4930 | 2020-03-25 |
1104451525 | Dr Paul Poulakos Do, LLC | Clinic/Center | 186 9th Ave Apt 4f, New York, NY 10011-4918 | 2020-03-05 |
1538793732 | Yi Zhang Medical Wellness Pllc | Clinic/Center | 3815 Corporal Stone St Fl 2, Bayside, NY 11361-2140 | 2020-02-26 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.