| Larry Consenstein, MD | |
|
301 Prospect Ave, Syracuse, NY 13203-1807 | |
| (315) 448-5861 | |
| Not Available |
| Full Name | Larry Consenstein |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Neonatal-perinatal Medicine |
| Location | 301 Prospect Ave, Syracuse, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285654988 | NPI | - | NPPES |
| 2698064 | Other | NY | GHI |
| 786 | Other | NY | TOTAL CARE |
| 325456 | Other | NY | MVP |
| 040426015097 | Other | NY | FIDELIS |
| 2080N0001X | Other | NY | TAXONOMY |
| 00680286 | Medicaid | NY | |
| 10767197 | Other | NY | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 139251 (New York) | Primary |
| 2080S0012X | Pediatrics - Sleep Medicine | 139251 (New York) | Secondary |
| Entity Name | Pediatric Service Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770539066 PECOS PAC ID: 9931007200 Enrollment ID: O20031223000483 |
| Mailing Address | Practice Location Address |
|---|---|
| Larry Consenstein, MD 301 Prospect Ave, Rm 5314, Syracuse, NY 13203-1807 Ph: (315) 448-5287 | Larry Consenstein, MD 301 Prospect Ave, Syracuse, NY 13203-1807 Ph: (315) 448-5861 |
Ms. Bonnie Lee Marr I, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 736 Irving Ave Ste 9100, Syracuse, NY 13210 Phone: 315-470-7379 Fax: 315-470-2923 | |
Dr. David William Hansen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3229 E. Genesee St, Suite 1, Syracuse, NY 13214 Phone: 315-464-5726 Fax: 315-464-2510 | |
Dr. Audrey Victoria Vandewall, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 750 E Adams St, Syracuse, NY 13210 Phone: 315-408-5854 | |
Shauna Thariath, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 725 East Adams St, 4th Fl, Syracuse, NY 13210 Phone: 315-464-5831 Fax: 315-464-2030 | |
Dr. Faruk Oktem, Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 725 Irving Ave, Ste 805, Syracuse, NY 13210 Phone: 315-464-6340 Fax: 315-464-6329 | |
Dr. Aisha Sultana Baig, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 750 East Adam St, Syracuse, NY 13210 Phone: 315-464-6323 Fax: 315-464-6322 | |
Megan A Pinnamaneni, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 750 E Adams St, Syracuse, NY 13210 Phone: 315-464-5420 |