# M R GORIGANTI PHYSICIAN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508049032
- **Authorized official:** DR. MAHENDER RAO GORIGANTI MD (MEMBER)
- **Authorized official phone:** (315) 423-4155

## Contact information

- **Practice address:** 1000 E GENESEE ST STE 100A, SYRACUSE, NY 13210-1853
- **Practice address phone:** (315) 423-4155
- **Practice address fax:** (315) 423-4199
- **Mailing address:** 1000 E GENESEE ST STE 100A, SYRACUSE, NY 13210-1853
- **Mailing address phone:** (315) 423-4155
- **Mailing address fax:** (315) 423-4199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 210930 | NY | Yes |
| 2081N0008X | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | 210930 | NY | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 210930 | NY | — |

## Other

- **Enumeration date:** 12/06/2007
- **Last updated:** 04/20/2008