Provider Demographics
NPI:1326019787
Name:ESRIG, BARRY CHARLES (MD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:CHARLES
Last Name:ESRIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 EAST ADAMS ST
Mailing Address - Street 2:SUITE 4835
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-1800
Mailing Address - Fax:315-464-6238
Practice Address - Street 1:750 EAST ADAMS ST
Practice Address - Street 2:SUITE 4835
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-1800
Practice Address - Fax:315-464-6238
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432770208G00000X
NY112405208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020040660001Medicaid
NY01872595Medicaid
PA1020040660001Medicaid
PA116756N8NMedicare PIN
A46709Medicare UPIN