Provider Demographics
NPI:1942251178
Name:SYNERGY BARIATRICS, PC
Entity Type:Organization
Organization Name:SYNERGY BARIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARUANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:7165-659-3990
Mailing Address - Street 1:30 N UNION RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5367
Mailing Address - Country:US
Mailing Address - Phone:716-565-3990
Mailing Address - Fax:716-565-3988
Practice Address - Street 1:30 N UNION RD
Practice Address - Street 2:STE 104
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5367
Practice Address - Country:US
Practice Address - Phone:716-565-3990
Practice Address - Fax:716-565-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTAX ID #
NY=========OtherTAX ID #