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Organization
NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC
Active
Organization
NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC
Active
Other names
New York Spine and Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TISO (MD/DIRECTOR)
(315) 552-6700
Entity
Organization
Contact information
Practice address
5100 W TAFT RD STE 1B, LIVERPOOL, NY 13088-3808
(315) 552-6739
Mailing address
PO BOX 510, SYRACUSE, NY 13214-0510
(315) 251-3105
(315) 552-6018
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/10/2015
Last updated
11/04/2020
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