Organization
UPSTATE EMERGENCY MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY A. JOHNSON (CHAIRMAN OF DEPARTMENT)
(315) 464-4363
Entity
Organization
Contact information
Practice address
750 E. ADAMS ST., SYRACUSE, NY 13210
(315) 464-4363
(315) 464-8690
Mailing address
750 E. ADAMS ST., SYRACUSE, NY 13210
(315) 464-4363
(315) 464-8690
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01713831
—
NY
Enumeration date
05/26/2006
Last updated
10/22/2010
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