Organization
CNY GASTROENTEROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYEES NIZAM MD (PRESIDENT)
(315) 252-0810
Entity
Organization
Contact information
Practice address
77 NELSON ST, SUITE 240, AUBURN, NY 13021-1944
(315) 252-0810
(315) 252-5179
Mailing address
PO BOX 2337, SYRACUSE, NY 13220-2337
(315) 422-6705
(315) 422-3909
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02974656
—
NY
Enumeration date
05/22/2006
Last updated
07/18/2008
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