Organization
M R GORIGANTI PHYSICIAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHENDER RAO GORIGANTI MD (MEMBER)
(315) 423-4155
Entity
Organization
Contact information
Practice address
1000 E GENESEE ST STE 100A, SYRACUSE, NY 13210-1853
(315) 423-4155
(315) 423-4199
Mailing address
1000 E GENESEE ST STE 100A, SYRACUSE, NY 13210-1853
(315) 423-4155
(315) 423-4199
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
210930
NY
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
210930
NY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
210930
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02283232
—
NY
01
—
1144202805
PROVIDER NPI
NY
Enumeration date
12/06/2007
Last updated
04/20/2008
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