Provider Demographics
NPI:1972696532
Name:UROLOGY CONSULTANTS OF SYRACUSE
Entity Type:Organization
Organization Name:UROLOGY CONSULTANTS OF SYRACUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRONHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-471-0190
Mailing Address - Street 1:739 IRVING AVENUE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1663
Mailing Address - Country:US
Mailing Address - Phone:315-471-0190
Mailing Address - Fax:315-471-0170
Practice Address - Street 1:739 IRVING AVENUE
Practice Address - Street 2:SUITE 600
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1663
Practice Address - Country:US
Practice Address - Phone:315-471-0190
Practice Address - Fax:315-471-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA0950OtherRAILROAD MEDICARE
NY00706905Medicaid
NY38694AMedicare ID - Type UnspecifiedMEDICARE GROUP ID