Organization
CNY OPHTHALMOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY RICCARDI MD (OWNER)
(315) 492-5910
Entity
Organization
Contact information
Practice address
4900 BROAD RD, NORTH SUITE 3P, SYRACUSE, NY 13215-2265
(315) 492-5910
Mailing address
PO BOX 2003, EAST SYRACUSE, NY 13057
(315) 446-3904
(315) 445-2936
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH8406
RRMCR
—
Enumeration date
03/03/2006
Last updated
10/18/2007
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