Provider Demographics
NPI:1184797383
Name:JEFFREY A. WINFIELD, M.D.,PH.D.,PC
Entity type:Organization
Organization Name:JEFFREY A. WINFIELD, M.D.,PH.D.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WINFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-475-3999
Mailing Address - Street 1:1000 E GENESEE ST
Mailing Address - Street 2:SUITE 602
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1892
Mailing Address - Country:US
Mailing Address - Phone:315-475-3999
Mailing Address - Fax:
Practice Address - Street 1:1000 E GENESEE ST
Practice Address - Street 2:SUITE 602
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1892
Practice Address - Country:US
Practice Address - Phone:315-475-3999
Practice Address - Fax:315-475-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1632371207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00907915Medicaid
NY00907915Medicaid
39980BMedicare ID - Type Unspecified