Syracuse Medical PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SYRACUSE MEDICAL PC

Practice address

3452 State Route 31
Ste 3
Baldwinsville, NY 13027-9231

Phone

(315) 622-0102

Fax

(315) 622-0112

NPI assigned

Mar 6, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jemille Smith, MD

Title

Owner

Phone

(315) 622-0102

Specialties & licenses 1

Addresses

Other names 1

• SYRACUSE MEDICAL & AESTHETICS Doing business as

Locations

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1770909335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 STATE ROUTE 31",
            "address_2": "STE 3",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130279231",
            "telephone_number": "315-622-0102",
            "fax_number": "315-622-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3452 STATE ROUTE 31",
            "address_2": "STE 3",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130279231",
            "telephone_number": "315-622-0102",
            "fax_number": "315-622-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYRACUSE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEMILLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-622-0102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SYRACUSE MEDICAL & AESTHETICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Baldwinsville, NY
• Providers in Baldwinsville, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.