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Organization

NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC

Active
Other names
New York Spine and Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT TISO (MD/DIRECTOR)
(315) 552-6700
Entity
Organization

Contact information

Practice address
5100 W TAFT RD STE 1B, LIVERPOOL, NY 13088-3808
(315) 552-6739
Mailing address
PO BOX 510, SYRACUSE, NY 13214-0510
(315) 251-3105
(315) 552-6018

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03423585
NY
Enumeration date
12/10/2015
Last updated
11/04/2020
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