Organization
ROME SURGICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH A BULAWA MD (PARTNER)
(315) 337-0202
Entity
Organization
Contact information
Practice address
7900 TURIN RD, BLDG 2 SUITE 3, ROME, NY 13440-1900
(315) 337-0202
(315) 337-8188
Mailing address
PO BOX 2003, EAST SYRACUSE, NY 13057-4503
(315) 446-3904
(315) 445-2936
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01976787
—
NY
Enumeration date
09/21/2005
Last updated
11/20/2008
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