Individual
GENNADY BRATSLAVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-6106
(315) 464-6117
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-6106
(315) 464-6117
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
0101237809
VA
208800000X
Urology Physician
Primary
260761
NY
208800000X
Urology Physician
MD450595
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03329242
—
NY
Enumeration date
06/22/2009
Last updated
01/29/2014
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