Provider Demographics
NPI:1467438234
Name:ALLYN, WILLIAM SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SCOTT
Last Name:ALLYN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:STE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2859
Mailing Address - Country:US
Mailing Address - Phone:315-472-1488
Mailing Address - Fax:315-472-8060
Practice Address - Street 1:5566 JORDAN RD
Practice Address - Street 2:
Practice Address - City:ELBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:13060-9617
Practice Address - Country:US
Practice Address - Phone:315-689-1833
Practice Address - Fax:315-689-1834
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-08-14
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Provider Licenses
StateLicense IDTaxonomies
NY192213207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF66638Medicare UPIN
NY080067467Medicare PIN