Organization
SYRACUSE NEUROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KUMAR BHAGAVATULA MD (PHYSICIAN/ OWNER)
(315) 492-5430
Entity
Organization
Contact information
Practice address
4900 BROAD RD, POB NORTH SUITE 3D, SYRACUSE, NY 13215-2265
(315) 492-5430
(315) 492-5431
Mailing address
1001 W FAYETTE ST, SUITE 400, SYRACUSE, NY 13204-2859
(315) 472-1488
(315) 472-8060
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
09/22/2006
Last updated
09/23/2008
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