# NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** New York Spine and Wellness Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770958100
- **Authorized official:** ROBERT TISO (MD/DIRECTOR)
- **Authorized official phone:** (315) 552-6700

## Contact information

- **Practice address:** 5100 W TAFT RD STE 1B, LIVERPOOL, NY 13088-3808
- **Practice address phone:** (315) 552-6739
- **Mailing address:** PO BOX 510, SYRACUSE, NY 13214-0510
- **Mailing address phone:** (315) 251-3105
- **Mailing address fax:** (315) 552-6018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/10/2015
- **Last updated:** 11/04/2020