Provider Demographics
NPI:1982024204
Name:SYRACUSE ORTHOPEDIC SPECIALISTS, PC
Entity Type:Organization
Organization Name:SYRACUSE ORTHOPEDIC SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-251-3100
Mailing Address - Street 1:5824 WIDEWATERS PKWY
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-3072
Mailing Address - Country:US
Mailing Address - Phone:315-251-3105
Mailing Address - Fax:
Practice Address - Street 1:6800 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13066-1089
Practice Address - Country:US
Practice Address - Phone:315-449-4118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty