Provider Demographics
NPI:1942756317
Name:SUNRISE SYRACUSE
Entity Type:Organization
Organization Name:SUNRISE SYRACUSE
Other - Org Name:SUNRISE SYRACUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THAKUR
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMSINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-289-3260
Mailing Address - Street 1:2201 GRANT BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208-2209
Mailing Address - Country:US
Mailing Address - Phone:315-289-3260
Mailing Address - Fax:
Practice Address - Street 1:2201 GRANT BLVD APT 1
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208-2209
Practice Address - Country:US
Practice Address - Phone:315-289-3260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health