Individual
LARRY CONSENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5861
Mailing address
301 PROSPECT AVE, RM 5314, SYRACUSE, NY 13203-1807
(315) 448-5287
(315) 448-6167
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
139251
NY
2080S0012X
Pediatric Sleep Medicine Physician
139251
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00680286
—
NY
01
—
040426015097
FIDELIS
NY
01
—
10767197
BLUE SHIELD
NY
01
—
2080N0001X
TAXONOMY
NY
01
—
2698064
GHI
NY
01
—
325456
MVP
NY
01
—
786
TOTAL CARE
NY
Enumeration date
07/19/2006
Last updated
07/21/2014
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