Provider Demographics
NPI:1124190160
Name:RESPIRATORY THERAPY RESOURCES PLLC
Entity Type:Organization
Organization Name:RESPIRATORY THERAPY RESOURCES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEGERE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:315-488-8087
Mailing Address - Street 1:326 FAY RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-1612
Mailing Address - Country:US
Mailing Address - Phone:315-488-8087
Mailing Address - Fax:315-468-5488
Practice Address - Street 1:326 FAY RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13219-1612
Practice Address - Country:US
Practice Address - Phone:315-488-8087
Practice Address - Fax:315-468-5488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003062-1227900000X
293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty
No293D00000XLaboratoriesPhysiological LaboratoryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CC4431Medicare UPIN