Provider Demographics
NPI:1245993518
Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF CNY, PC
Entity type:Organization
Organization Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF CNY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:NOTARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-472-7504
Mailing Address - Street 1:5008 BRITTONFIELD PKWY STE 700
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9249
Mailing Address - Country:US
Mailing Address - Phone:315-472-7504
Mailing Address - Fax:315-634-4419
Practice Address - Street 1:5008 BRITTONFIELD PKWY STE 700
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9249
Practice Address - Country:US
Practice Address - Phone:315-472-7504
Practice Address - Fax:315-634-4419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00821554Medicaid