Provider Demographics
NPI:1336131150
Name:AUBURN MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:AUBURN MEMORIAL HOSPITAL
Other - Org Name:FINGER LAKES FAMILY MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUBURN HOSPITAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-255-7011
Mailing Address - Street 1:PO BOX 2004
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-4504
Mailing Address - Country:US
Mailing Address - Phone:315-449-2208
Mailing Address - Fax:315-445-2936
Practice Address - Street 1:3418 CENTER ROAD
Practice Address - Street 2:
Practice Address - City:SCIPIO CENTER
Practice Address - State:NY
Practice Address - Zip Code:13147
Practice Address - Country:US
Practice Address - Phone:315-364-3525
Practice Address - Fax:315-255-7382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty