Organization
CROUSE IRVING MEMORIAL ELECTROCARDIOGRAPHIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LONGO MD (PRESIDENT)
(315) 470-7489
Entity
Organization
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7489
Mailing address
PO BOX 2003, EAST SYRACUSE, NY 13057-4503
(315) 446-3904
(315) 552-6590
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00589322
—
NY
01
—
CK1481
RRMCR
—
Enumeration date
03/03/2006
Last updated
01/19/2012
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