| Octaviani Medicine Pc | |
|
1223 N Salina St Syracuse NY 13208-1519 | |
| (315) 703-3263 | |
| Not Available |
| Full Name | Octaviani Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1223 N Salina St, Syracuse, New York |
| Authorized Official Name and Position | Denise Octaviani (PRESIDENT - OWNER) |
| Authorized Official Contact | 3157033263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Octaviani Medicine Pc 1223 N Salina St Syracuse NY 13208-1519 Ph: (315) 703-3263 | Octaviani Medicine Pc 1223 N Salina St Syracuse NY 13208-1519 Ph: (315) 703-3263 |
| NPI Number | 1437517463 |
|---|---|
| Provider Enumeration Date | 02/04/2016 |
| Last Update Date | 02/04/2016 |
| Medicare PECOS PAC ID | 4880985704 |
|---|---|
| Medicare Enrollment ID | O20160624000259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437517463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 197696 (New York) | Primary |
| Provider Name | Denise Octaviani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841286325 PECOS PAC ID: 0840233029 Enrollment ID: I20050608000682 |
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