Provider Demographics
NPI:1700109956
Name:ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC
Entity Type:Organization
Organization Name:ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC
Other - Org Name:CNY UROLOGY ROME
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-478-4185
Mailing Address - Street 1:1226 E WATER ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1155
Mailing Address - Country:US
Mailing Address - Phone:315-478-4185
Mailing Address - Fax:
Practice Address - Street 1:1617 N JAMES ST
Practice Address - Street 2:SUITE 900
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-2852
Practice Address - Country:US
Practice Address - Phone:315-336-0499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-02
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6134580006Medicare NSC