Eastside Pediatric Group, LLP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

EASTSIDE PEDIATRIC GROUP, LLP

Practice address

5900 N Burdick St
East Syracuse, NY 13057-9462

Phone

(315) 656-8750

Fax

(315) 656-8493

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Eleanor Williams, M.D.NPI 1821038464

Title

Senior Partner

Phone

(315) 656-8750

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eleanor Williams, MD

  • Pediatrics Physician
  • East Syracuse, NY
  • NPI 1821038464
  Authorized official Same address or phone

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134212319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 N BURDICK ST",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579462",
            "telephone_number": "315-656-8750",
            "fax_number": "315-656-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N BURDICK ST",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579462",
            "telephone_number": "315-656-8750",
            "fax_number": "315-656-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE PEDIATRIC GROUP, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "315-656-8750",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01397373",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Syracuse Minoa Central School District
• East Syracuse Minoa CSD
• East Syracuse Minoa CSD
• East Syracuse Minoa School District
• Jillian L Eastman, NPC
• Matthew William Eddy, MSPT
• Marissa Nicole Edwards, CPNP-PC
• Deborah Egerter-Foley, NP
• Carl Paul Ellerman, MSW, PH.D.
• Ann Driscoll Elliott

• Pediatrics Physician in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.