Provider Demographics
NPI:1730134503
Name:SARATOGA EAR & SINUS SURGERY, PC
Entity Type:Organization
Organization Name:SARATOGA EAR & SINUS SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-587-2300
Mailing Address - Street 1:54 SEWARD ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-1143
Mailing Address - Country:US
Mailing Address - Phone:518-587-2300
Mailing Address - Fax:518-587-2656
Practice Address - Street 1:54 SEWARD ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1143
Practice Address - Country:US
Practice Address - Phone:518-587-2300
Practice Address - Fax:518-587-2656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1172401207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0019Medicare ID - Type UnspecifiedMEDICARE GROUP #