Organization
CNY NEURODIAGNOSTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMAH OMER MOHIUDDIN M.D. (OWNER)
(315) 481-8777
Entity
Organization
Contact information
Practice address
1101 ERIE BLVD E, SYRACUSE, NY 13210-1148
(315) 481-8777
(315) 782-8699
Mailing address
445 FACTORY ST, WATERTOWN, NY 13601-2729
(315) 782-4207
(315) 786-8699
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
266512
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NY
Enumeration date
01/27/2015
Last updated
01/27/2015
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