1174590657

Everything you always wanted to know about CROUSE IRVING MEMORIAL ELECTROCARDIOGRAPHIC GROUP LONGO JAMES but were afraid to ask.

CROUSE IRVING MEMORIAL ELECTROCARDIOGRAPHIC GROUP LONGO JAMES

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Organization Name Authorized Official Last Name Authorized Official First Name
CROUSE IRVING MEMORIAL ELECTROCARDIOGRAPHIC GROUP LONGO JAMES
Gender:
none
Enumeration date:
2006-03-03
Last update date:
2012-01-19
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No

Identifiers

identifier description issuer state
53625A Medicare PIN none none
00589322 Medicaid none NY
CK1481 Other RRMCR none
CK1481 Medicare PIN none none

Taxonomies

Taxonomy State License Number Primary?
207RC0000X Cardiovascular Disease none none

Phone Numbers

Type Number
Mailing Address Telephone Number 3154463904
Practice Location Address Telephone Number 3154707489
Authorized Official Telephone Number 3154707489
Mailing Address Fax Number 3155526590

Addresses

Type Address City State Postal Country
Mailing Address PO BOX 2003 EAST SYRACUSE NY 13057 NY
Practice Location Address 736 IRVING AVE SYRACUSE NY 0 NY

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Organization
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Organization
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Organization
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Organization
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