Organization
COMMUNITY ECG ECHO GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN D JAFFE MD (DIRECTOR)
(315) 492-5973
Entity
Organization
Contact information
Practice address
4900 BROAD RD, SYRACUSE, NY 13215-2265
(315) 472-1488
(315) 472-8060
Mailing address
1001 W FAYETTE ST, STE 400, SYRACUSE, NY 13204-2859
(315) 472-1488
(315) 472-8060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01193662
—
NY
Enumeration date
07/23/2006
Last updated
04/20/2011
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