Individual
MICHAEL M TERSEGNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7551
(315) 470-2719
Mailing address
5008 BRITTONFIELD PKWY, SUITE 100, EAST SYRACUSE, NY 13057-9248
(315) 234-7600
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
162948
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01141193
—
NY
Enumeration date
08/30/2005
Last updated
07/12/2012
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