Provider Demographics
NPI:1023141652
Name:SYMPHONY,INC.
Entity type:Organization
Organization Name:SYMPHONY,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCELLINE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:BRUNSWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-643-0257
Mailing Address - Street 1:PO BOX 615
Mailing Address - Street 2:174 ROUNDHOUSE ROAD
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-0615
Mailing Address - Country:US
Mailing Address - Phone:607-643-0257
Mailing Address - Fax:607-643-0292
Practice Address - Street 1:174 ROUNDHOUSE ROAD
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820
Practice Address - Country:US
Practice Address - Phone:607-643-0257
Practice Address - Fax:607-643-0292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02039563332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02039563Medicaid
NY1287820001Medicare ID - Type UnspecifiedPROVIDER NUMBER