Provider Demographics
NPI:1386849230
Name:MADOM, LINDSAY MITCHELL (MD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MITCHELL
Last Name:MADOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5800 HERITAGE LANDING DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9378
Mailing Address - Country:US
Mailing Address - Phone:315-445-2701
Mailing Address - Fax:315-445-2847
Practice Address - Street 1:5800 HERITAGE LANDING DR
Practice Address - Street 2:SUITE C
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9378
Practice Address - Country:US
Practice Address - Phone:315-445-2701
Practice Address - Fax:315-445-2847
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY259003207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology