Individual
DR. MARK DAVID ADELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
770 JAMES ST STE 100B, SYRACUSE, NY 13203-2642
(315) 423-4222
(315) 423-0305
Mailing address
770 JAMES ST STE 100B, SYRACUSE, NY 13203-2642
(315) 423-4222
(315) 423-0305
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
161388
NY
207VG0400X
Gynecology Physician
Primary
161388
NY
207VX0201X
Gynecologic Oncology Physician
161388
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00897961
—
NY
01
—
161388
NYS LICENSE NUMBER
NY
01
—
161427195
TAX IDENTIFICATION NUMBER
NY
Enumeration date
02/14/2006
Last updated
03/13/2018
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