DEPARTMENT OF MEDICINE MEDICAL SERVICE GROUP (NPI# 1205104262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205104262 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF MEDICINE MEDICAL SERVICE GROUP |
| Other Organization Name | UNIVERSITY PHYSICIANS - HOMER |
| Practice Address |
82 Copeland Ave Homer NY 13077-1528 |
| Practice Telephone | 6077492640 |
| Practice Fax Number | 6077492644 |
| Mailing Telephone | 6077492640 |
| Mailing Fax Number | 6077492644 |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2014-09-02 |
| Authorized Official Name | MICHAEL IANNUZZI (MD) |
| Authorized Official Telephone | 3154643835 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00459903 | 05 |
| Other Name | Type Code |
|---|---|
| University Physicians - Homer | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225052772 | Department of Medicine Medical Service Group | Internal Medicine | 1000 E Genesee St, Suite 403, Syracuse, NY 13210-1892 | 2006-07-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DEPARTMENT OF MEDICINE MEDICAL SERVICE GROUP AT THE SUNY HEALTH SCIENCE CENTER AT SYRACUSE | 750 E Adam St, Syracuse, NY 13210-2306 |
| New York State Corporations | DEPARTMENT OF MEDICINE MEDICAL SERVICE GROUP AT THE SUNY HEALTH SCIENCE CENTER AT SYRACUSE INC. | Dept Medicine, Medical Service, Group, 750 East Adams Street, Syracuse, Ny 13210 |
| Street Address |
82 COPELAND AVE |
| City | HOMER |
| State | NY |
| Zip Code | 13077-1528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952380016 | Danielle Annette Bellumori | Nurse Practitioner | 82 Copeland Ave, Homer, NY 13077-1528 | 2006-01-16 |
| 1184076507 | Shamanthy Ratnasingam | Internal Medicine | 82 Copeland Ave, Homer, NY 13077-1528 | 2016-07-09 |
| 1609258680 | Gaurav Jaswal | Family Medicine | 82 Copeland Ave, Homer, NY 13077-1528 | 2015-06-25 |
| 1083902027 | Lisa A Olson-gugerty | Nurse Practitioner | 82 Copeland Ave, Homer, NY 13077-1528 | 2011-07-12 |
| 1861563660 | Andras Szabo | Internal Medicine | 82 Copeland Ave, Homer, NY 13077-1528 | 2006-11-13 |
| 1386652030 | Patricia J Curtin | Nurse Practitioner | 82 Copeland Ave, Homer, NY 13077-1528 | 2006-08-04 |
| 1811964281 | Jacqueline Joy Gagen | Obstetrics & Gynecology | 82 Copeland Ave, Homer, NY 13077 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760024434 | Mindful Harmony LLC | Massage Therapist | 6 N. Main St, Homer, NY 13077 | 2019-10-14 |
| 1982947990 | Robin L Staring | Licensed Practical Nurse | 43 North Main St, Homer, NY 13077 | 2013-03-28 |
| 1760703227 | Krista C Keeler | Social Worker | 24 Copeland Avenue, Homer, NY 13077 | 2010-06-18 |
| 1740339704 | Ashley C Vormwald | Speech-Language Pathologist | 9 Central Park Place, Homer, NY 13077 | 2007-01-09 |
| 1497846844 | Ehren Paul Heyer | Physical Therapist | 84 Cortland St., Homer, NY 13077 | 2006-09-28 |
| 1255351813 | Sandi H Wallace | Physical Therapist | 59 A James St., Homer, NY 13077 | 2006-07-19 |
| 1700866217 | Robert P Morris | Dermatology | 45 N Fulton St, Homer, NY 13077 | 2006-01-19 |
| 1528342052 | Heidi Jean Effinger | Social Worker | 72 S Main St, Homer, NY 13077 | 2011-10-03 |
| 1407094345 | Elaine Elizabeth Fisher | Speech-Language Pathologist | 65 James St, Homer, NY 13077 | 2009-01-30 |
| 1386706299 | Robert B Slater | Social Worker | 24 Copeland Ave, Homer, NY 13077 | 2006-12-15 |
| Find all providers in zip 13077 | ||||
| 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 |
| Find all providers with the same taxonomy | ||||
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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.