Provider Demographics
NPI:1235242017
Name:ADIRONDACK SURGICAL GROUP LLP
Entity Type:Organization
Organization Name:ADIRONDACK SURGICAL GROUP LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LIEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-891-1610
Mailing Address - Street 1:309 COUNTY ROUTE 47
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983
Mailing Address - Country:US
Mailing Address - Phone:518-891-1610
Mailing Address - Fax:518-891-5726
Practice Address - Street 1:309 COUNTY ROUTE 47
Practice Address - Street 2:SUITE 4
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983
Practice Address - Country:US
Practice Address - Phone:518-891-1610
Practice Address - Fax:518-891-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY33431AMedicare ID - Type UnspecifiedGROUP