Provider Demographics
NPI:1770661225
Name:SYRACUSE VETERANS HOSPITAL
Entity Type:Organization
Organization Name:SYRACUSE VETERANS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HIM COMPLIANCE OFFICER FOIA OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEROY
Authorized Official - Suffix:
Authorized Official - Credentials:BS,CCS,CCP
Authorized Official - Phone:315-425-4400
Mailing Address - Street 1:406 BALSAM ST
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-5002
Mailing Address - Country:US
Mailing Address - Phone:315-299-5992
Mailing Address - Fax:
Practice Address - Street 1:800 IRVING AVENUE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-0000
Practice Address - Country:US
Practice Address - Phone:315-425-4400
Practice Address - Fax:315-425-2639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304386-12865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital