PEDIATRIC SERVICE GROUP (NPI# 1770539066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770539066 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SERVICE GROUP |
| Practice Address |
750 E. Adams St. 5th Floor Syracuse NY 13210 |
| Practice Telephone | 3154645450 |
| Practice Fax Number | 3154647564 |
| Mailing Telephone | 3154645450 |
| Mailing Fax Number | 3154647564 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2010-10-22 |
| Authorized Official Name | DR. THOMAS WELCH (CHAIRMAN OF DEPARTMENT) |
| Authorized Official Telephone | 3154645450 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01215750 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356541650 | Pediatric Service Group | Legal Medicine | 4308 Belmont Ave, Youngstown, OH 44505-1052 | 2007-07-24 |
| Street Address |
750 E. ADAMS ST. 5TH FLOOR |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659637718 | Molly W. Harris | Occupational Therapist | 750 E. Adams St., Physical Medicine & Rehabilitation, Syracuse, NY 13210 | 2012-04-03 |
| 1396067153 | Najib Safieddine | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 750 E. Adams St., Syracuse, NY 13210 | 2010-02-22 |
| 1922267632 | George David Annas | Psychiatry & Neurology | 750 E. Adams St., Syracuse, NY 13210 | 2008-06-06 |
| 1104002542 | Mary P D'addario | Pharmacist | 750 E. Adams St., Rm 1512, Syracuse, NY 13210 | 2008-01-16 |
| 1023102548 | Irene Alexandra Lough | Nurse Practitioner | 750 E. Adams St., Syracuse, NY 13210 | 2006-10-02 |
| 1275589582 | Upstate Emergency Medicine, Inc | Emergency Medicine | 750 E. Adams St., Syracuse, NY 13210 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
| 1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
| 1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
| 1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
| 1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
| 1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
| 1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
| 1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
| Find all providers in zip 13210 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386194967 | Diane B Montgomery | Pediatrics | 1045 James St Ste 270, Syracuse, NY 13203-2791 | 2016-10-07 |
| 1285995324 | Jenica O'malley | Pediatrics | 90 Presidental Plaza 3rd Fl, Syracuse, NY 13202 | 2012-06-05 |
| 1487949913 | Angela Patricia Mojica Sanabria | Pediatrics | 3229 East Genesee St Ste 1, Syracuse, NY 13214 | 2011-06-13 |
| 1003105768 | David William Hansen | Pediatrics | 3229 E. Genesee St, Suite 1, Syracuse, NY 13214 | 2011-04-04 |
| 1760700108 | Christopher John Prendergast | Pediatrics | 725 Irving Ave Ste 804, Syracuse, NY 13210-1682 | 2010-05-10 |
| 1407007628 | Ahmad Ismail El Samra | Pediatrics | 600 James St, Apt 603, Syracuse, NY 13203-2254 | 2008-10-07 |
| 1235347915 | Frederick Goldberg | Pediatrics | Community General Hospital, 4900 Broad Road, Syracuse, NY 13215 | 2007-05-18 |
| 1679780308 | Juanita M Welnicki | Pediatrics | 5062 Skyline Dr, Syracuse, NY 13215-2444 | 2007-05-16 |
| 1801985262 | Nicholas T Massa | Pediatrics | 475 Irving Ave Ste 210, Syracuse, NY 13210-1529 | 2006-10-12 |
| 1992714117 | Shailaja Potdar | Pediatrics | 603 Oswego St, Syracuse, NY 13204-3127 | 2006-08-05 |
| Find all providers in SYRACUSE | ||||
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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.