Individual
SPHOORTHI JINNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
5823 WIDEWATERS PKWY, EAST SYRACUSE, NY 13057-3084
(315) 500-7546
Mailing address
5823 WIDEWATERS PKWY, EAST SYRACUSE, NY 13057-3084
(315) 500-7546
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
292483
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2013
Last updated
07/22/2025
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