Organization
NEUROLOGY MEDICAL SERVICE GROUP, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS J. MEJICO MD (PRESIDENT)
(315) 464-2014
Entity
Organization
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-5302
(315) 464-5355
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-5302
(315) 464-5355
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02635789
—
NY
Enumeration date
06/06/2006
Last updated
03/15/2021
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