Provider Demographics
NPI:1649324765
Name:SARATOGA SURGICAL SPECIALISTS, PC
Entity type:Organization
Organization Name:SARATOGA SURGICAL SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:FLETCHER
Authorized Official - Last Name:STARNES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:518-581-1100
Mailing Address - Street 1:381 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-8626
Mailing Address - Country:US
Mailing Address - Phone:518-581-1100
Mailing Address - Fax:518-581-0233
Practice Address - Street 1:381 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-8626
Practice Address - Country:US
Practice Address - Phone:518-581-1100
Practice Address - Fax:518-581-0233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56438AMedicare ID - Type Unspecified
NYCK2374Medicare PIN