Cny Pain Management Medical Suite, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

215662 Issued in NY

Legal business name

CNY PAIN MANAGEMENT MEDICAL SUITE, PC

Practice address

59 South First Street
Fulton, NY 13069

Phone

(315) 593-7715

Fax

(315) 593-1495

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Mahesh Reddy Kuthuru, MD

Title

President

Phone

(315) 593-7715

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962614065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 SOUTH FIRST STREET",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "13069",
            "telephone_number": "315-593-7715",
            "fax_number": "315-593-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 SOUTH FIRST STREET",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "13069",
            "telephone_number": "315-593-7715",
            "fax_number": "315-593-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CNY PAIN MANAGEMENT MEDICAL SUITE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUTHURU",
        "authorized_official_first_name": "MAHESH",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-593-7715",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "215662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farzana Chaudhary, MD
• Chuyang Chen
• Sharon Reynolds Chernoff, LPN
• Gabrielle Sunshine Chrestler
• Ashley Clarke-Arnold
• Rosemary Collins, RN
• Community Chiropractic, P.C.
• Lisa Maureen Connolly, L.P.N.
• Caryn E Conway, M.S CCC-SLP
• Hayden Cook

• Specialist in Fulton, NY
• Providers in Fulton, NY by specialty
• Specialist 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.