Provider Demographics
NPI:1679707772
Name:MH-CNY-FL MEDICAL PC
Entity Type:Organization
Organization Name:MH-CNY-FL MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:RIAZ
Authorized Official - Middle Name:SIBTAIN
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-475-3178
Mailing Address - Street 1:109 SOUTH WARREN STREET
Mailing Address - Street 2:SUITE 1605
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202
Mailing Address - Country:US
Mailing Address - Phone:315-475-3178
Mailing Address - Fax:315-682-3879
Practice Address - Street 1:109 SOUTH WARREN ST.
Practice Address - Street 2:SUITE 1605
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202
Practice Address - Country:US
Practice Address - Phone:315-475-3178
Practice Address - Fax:315-682-3879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1376592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty