NPIMap

Organization Active NPI

Internist Associates of Central New York, PC

  • Clinical Medical Laboratory
  • Syracuse, NY
National Provider Identifier
1063481067
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
33DO166447 Issued in NY
Legal business name
INTERNIST ASSOCIATES OF CENTRAL NEW YORK, PC
Practice address
739 Irving Ave
Suite 350
Syracuse, NY 13210-1640
Phone
(315) 479-5070
Fax
(315) 701-2520
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary M Oonk
Title
HR Manager
Phone
(315) 479-5070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 33DO166447 NY Primary

Addresses

Primary practice location

739 Irving Ave
Suite 350
Syracuse, NY 13210-1640

Mailing address

739 Irving Ave
Suite 350
Syracuse, NY 13210-1640
Phone (315) 479-5070

Other identifiers 1

IdentifierTypeStateIssuer
01153415MedicaidNY

Other names 1

  • Internist Associates of Central New York Clinical Laboratory Other name

National Provider Directory

National Provider Directory

Locations

5000 Brittonfield Pkwy
Ste A100
East Syracuse, NY 13057
Phone (315) 449-3800

725 Irving Ave
Ste 505
Syracuse, NY 13210
Phone (315) 470-7027

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273708800000",
    "number": "1063481067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 350",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101640",
            "telephone_number": "315-479-5070",
            "fax_number": "315-701-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 350",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101640",
            "telephone_number": "315-479-5070",
            "fax_number": "315-701-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNIST ASSOCIATES OF CENTRAL NEW YORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-05-13",
        "status": "A",
        "authorized_official_last_name": "OONK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "HR MANAGER",
        "authorized_official_telephone_number": "315-479-5070"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "33DO166447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01153415",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internist Associates of Central New York Clinical Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.