Provider Demographics
NPI:1932311263
Name:CNY PLASTIC SURGEONS, PC
Entity Type:Organization
Organization Name:CNY PLASTIC SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:ARMENTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-476-7459
Mailing Address - Street 1:2200 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2298
Mailing Address - Country:US
Mailing Address - Phone:315-476-7459
Mailing Address - Fax:315-471-4036
Practice Address - Street 1:2200 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2298
Practice Address - Country:US
Practice Address - Phone:315-476-7459
Practice Address - Fax:315-471-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1307628174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherOTHER
NY=========Medicare UPIN
NY=========OtherOTHER