Organization
NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC
Active
Other names
New York Spine and Wellness Center, New York Spine & Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L TISO (MD)
(315) 251-3105
Entity
Organization
Contact information
Practice address
6430 TRANSIT RD STE 300, DEPEW, NY 14043-1033
(315) 552-6700
Mailing address
PO BOX 510, SYRACUSE, NY 13214-0510
(315) 251-3105
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03423585
—
NY
Enumeration date
12/10/2015
Last updated
01/07/2021
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