DEPARTMENT OF MEDICINE MSG (NPI# 1174543979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174543979 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF MEDICINE MSG |
| Other Organization Name | UNIVERSITY PHYSICIANS-OSWEGO |
| Practice Address |
140 W 6th St Suite 110 Oswego NY 13126-2525 |
| Practice Telephone | 3153426215 |
| Practice Fax Number | 3153426219 |
| Mailing Telephone | 3153426215 |
| Mailing Fax Number | 3153426219 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-07-16 |
| Authorized Official Name | MICHAEL C. IANNUZZI (PRESIDENT) |
| Authorized Official Telephone | 3154644505 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | NY | Suppliers | |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00459903 | 05 |
| Other Name | Type Code |
|---|---|
| University Physicians-Oswego | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699799148 | Department of Medicine Msg | Durable Medical Equipment & Medical Supplies | 90 Presidential Plz, Syracuse, NY 13202-2240 | 2006-07-27 |
| 1205856093 | Department of Medicine Msg | Internal Medicine | 102 W Seneca St, Manlius, NY 13104-2480 | 2006-07-21 |
| 1871513689 | Department of Medicine Msg | Durable Medical Equipment & Medical Supplies | 1000 E Genesee St, Suites 205 & 206, Syracuse, NY 13210-1892 | 2006-07-21 |
| 1396765632 | Department of Medicine Msg | Durable Medical Equipment & Medical Supplies | 550 Harrison St, Suite 200, Syracuse, NY 13202-3096 | 2006-07-20 |
| Street Address |
140 W 6TH ST SUITE 110 |
| City | OSWEGO |
| State | NY |
| Zip Code | 13126-2525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619979374 | Melanie Lynn Groch | Otolaryngology | 140 W 6th St, Suite 210, Oswego, NY 13126-2525 | 2005-08-12 |
| 1619416203 | Rahul Rangrao Shinde | Physician Assistant | 140 W 6th St, Oswego, NY 13126-2525 | 2017-02-16 |
| 1356621734 | Susan A Callaway | Registered Nurse | 140 W 6th St, Oswego, NY 13126-2525 | 2011-08-17 |
| 1740433176 | Joanne Lynn Broadwell | Clinic/Center | 140 W 6th St, Suite 140, Oswego, NY 13126-2525 | 2008-10-29 |
| 1336345941 | Ronald Damani Howell | Orthopaedic Surgery | 140 W 6th St, Suite 220, Oswego, NY 13126-2525 | 2007-06-21 |
| 1447476254 | Minimally Invasive Surgery of Oswego County, Pllc | Specialist | 140 W 6th St, Suite 270, Oswego, NY 13126-2525 | 2007-04-18 |
| 1992863062 | William Mahon, Md PC | Orthopaedic Surgery | 140 W 6th St, Suite 210, Oswego, NY 13126-2525 | 2006-12-04 |
| 1568547339 | Baker Orthopaedics & Sports Medicine P C | Orthopaedic Surgery | 140 W 6th St, Suite 180, Oswego, NY 13126-2525 | 2006-10-27 |
| 1821195900 | Laura J Paoletti | Nurse Practitioner | 140 W 6th St, Suite 110, Oswego, NY 13126-2525 | 2006-09-20 |
| 1003839572 | David William Granoff | Otolaryngology | 140 W 6th St, Suite 180, Oswego, NY 13126-2525 | 2006-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303572 | Elise Fitzsimmons | Specialist/Technologist | 9 Laker Hall, Oswego, NY 13126 | 2020-10-15 |
| 1023651742 | Jessica Lynn Metzger | Physician Assistant | 300 Ny-104 Suite 1, Oswego, NY 13126 | 2019-10-25 |
| 1245887009 | Maureen Adams | Technician | 30 Stone Ridge Drive, Oswego, NY 13126 | 2019-08-26 |
| 1285128314 | Justin Raymond Beebe | Nurse Practitioner | 300 State Route 104 Ste 2, Oswego, NY 13126 | 2018-06-21 |
| 1801311220 | Lynne M Wallace | Registered Nurse | 29 Birch Lane 17b, Oswego, NY 13126 | 2017-08-07 |
| 1497203962 | Lindsay Cheslock | Local Education Agency (LEA) | 529 County Route 25, Oswego, NY 13126 | 2016-09-14 |
| 1942757919 | Aimee Devinny | Registered Nurse | 21 Twin Orchard Drive, Oswego, NY 13126 | 2016-09-07 |
| 1083160295 | Cameron Delmotte | Specialist | 159 West Frist Street, Oswego, NY 13126 | 2016-08-28 |
| 1508319187 | Samantha Thayer | Occupational Therapist | 159 West First Oswego St, Oswego, NY 13126 | 2016-07-29 |
| 1104279595 | Vikram Jala | Internal Medicine | 105 County Route 45a Ste 400, Oswego, NY 13126 | 2016-07-20 |
| Find all providers in zip 13126 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861058778 | Robert Lee De Jager | Internal Medicine | 27 Barker Ave Apt 403, White Plains, NY 10601-1559 | 2019-05-15 |
| 1033623178 | Advanced Care Associates LLC | Internal Medicine | 455 North End Avenue, Ground Floor, Welness Center, New York, NY 10282-5383 | 2017-11-28 |
| 1043738644 | Megan Greally | Internal Medicine | 303 East 60th Street Apartment 37e, New York, NY 10022 | 2017-09-03 |
| 1437675154 | Feng Hematology and Medical Oncology Pllc | Internal Medicine | 833 58th Street, Brooklyn, NY 11220 | 2017-08-15 |
| 1225552649 | George Norman Abraham | Internal Medicine | 600 Elmwood Avenue, University of Rochester, Rochester, NY 14642 | 2017-07-27 |
| 1376095901 | Carolyn Michele Paradise | Internal Medicine | 6 Gilman Ln, Cortlandt Manor, NY 10567-6204 | 2016-10-31 |
| 1821444001 | Advanced Hematology Oncology Pllc | Internal Medicine | 4235 Main St Ste 3h, Flushing, NY 11355-3956 | 2016-05-06 |
| 1174992184 | Tetyana Koulikova | Internal Medicine | 2272 63rd St Apt 2f, Brooklyn, NY 11204-3153 | 2015-09-20 |
| 1588031389 | Taha Oncology PC | Internal Medicine | 568b Buchanan Ave, Staten Island, NY 10314-4160 | 2015-08-27 |
| 1609251123 | Gene Resnick | Internal Medicine | 59 Alex Dr, White Plains, NY 10605-3414 | 2015-07-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.