Provider Demographics
NPI:1114011400
Name:SAPONARA, GERARD C (DPM)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:C
Last Name:SAPONARA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 NORTH BURDICK STREET
Mailing Address - Street 2:STE 104
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057
Mailing Address - Country:US
Mailing Address - Phone:315-656-2216
Mailing Address - Fax:315-656-2454
Practice Address - Street 1:5900 N BURDICK STREET
Practice Address - Street 2:STE 104
Practice Address - City:E SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057
Practice Address - Country:US
Practice Address - Phone:315-656-2216
Practice Address - Fax:315-656-2454
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP00001722213E00000X
NJ1651213E00000X
NYN3981213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00964576Medicaid
NYT26531Medicare UPIN
NY0337950002Medicare NSC
NY0337950001Medicare NSC