DR. BRUCE E FREDRICKSON (NPI# 1477558492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477558492 |
| Entity Type | Individual |
| Full Name | DR. BRUCE E FREDRICKSON |
| Credential | MD |
| Practice Address |
550 Harrison St Ste 130 Syracuse NY 13202-3064 |
| Practice Telephone | 3154644472 |
| Practice Fax Number | 3154645223 |
| Mailing Telephone | 3154644472 |
| Mailing Fax Number | 3154645223 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2007-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 122366 | NY | Allopathic & Osteopathic Physicians |
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
122366 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00522514 | 05 | |
| NY | LICENSE | 122366 | 01 |
| Street Address |
550 HARRISON ST STE 130 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13202-3064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750903852 | Andrew Joseph Laychur | Student in an Organized Health Care Education/Training Program | 550 Harrison St, Syracuse, NY 13202-3188 | 2020-05-12 |
| 1386281822 | Kirinjit Kaur | Physician Assistant | 550 Harrison St, Syracuse, NY 13202-3188 | 2019-12-03 |
| 1326442476 | Christopher John Norman | Nurse Practitioner | 550 Harrison St, Suite A - Geriatrics, Syracuse, NY 13202-3188 | 2014-10-17 |
| 1144566795 | Judith Ford Hamlin | Nurse Practitioner | 550 Harrison St, Suite 117, Syracuse, NY 13202-3188 | 2012-12-28 |
| 1154631760 | Ruben Pinkhasov | Urology | 550 Harrison St, Suite N, Syracuse, NY 13202 | 2010-10-15 |
| 1235461187 | Megan Leigh Lafave | Chiropractor | 550 Harrison St, Suite 100, Syracuse, NY 13202-3188 | 2010-02-03 |
| 1780828939 | Amit Goyal | Surgery | 550 Harrison St, Suite 330, Syracuse, NY 13202-3188 | 2009-04-30 |
| 1609016781 | Robert V. Bull | Pharmacist | 550 Harrison St, Syracuse, NY 13202-3188 | 2009-03-02 |
| 1740443548 | Department of Medicine | Military Hospital | 550 Harrison St, Suite 200, Syracuse, NY 13202-3188 | 2008-07-02 |
| 1487816005 | Robert T Swan | Ophthalmology | 550 Harrison St, Suite L, Syracuse, NY 13202-3188 | 2008-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255804456 | Lisa Blachford | Registered Nurse | 421 Montgomery St Room 80, Syracuse, NY 13202 | 2019-01-10 |
| 1851873640 | Syracuse Community Health Center, Inc. | Case Management | 819 South Salina Street, Syracuse, NY 13202 | 2018-08-29 |
| 1245739713 | Telibra Lloyd | Counselor | 375 W Onondaga St Suite 10, Syracuse, NY 13202 | 2018-02-09 |
| 1326574534 | Wendell Covell | Social Worker | 50 Presidential Plaza, Jefferson Tower Suite Ll05, Syracuse, NY 13202 | 2017-05-08 |
| 1083165005 | Candy Herbert | Counselor | 375 W. Onondaga St. Suite 10, Syracuse, NY 13202 | 2016-10-14 |
| 1427429760 | Joshua Caryl | Counselor | 319 East Water Street, Syracuse, NY 13202 | 2015-10-13 |
| 1093140956 | Jennifer B Mccaffrey | Nurse Practitioner | 421 Montgomery Street Room 80, Onondaga County Health Dept. Bureau of Disease Control, Syracuse, NY 13202 | 2013-09-11 |
| 1336581552 | Emily Renee Haggerty | Hospitalist | 500 Harrison St, 1705a, Syracuse, NY 13202 | 2013-07-30 |
| 1134470933 | Tanya Marie Harlec Mcguire | Genetic Counselor, MS | 90 Presdential Plaza Uhcc 3rd Fl., Regional Perinatal Center Suny Upstate Medical Ctr, Syracuse, NY 13202 | 2012-09-20 |
| 1104176320 | Mary Jo Maestri | Genetic Counselor, MS | 90 Presidential Plaza Uhcc- Perinatal Ceter, University Hospital/upstate Medical Center, Syracuse, NY 13202 | 2012-09-14 |
| Find all providers in zip 13202 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972562155 | Raman Dhawan | Orthopaedic Surgery | 739 Irving Ave, Suite 520, Chy Medical Center, Syracuse, NY 13210 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427442 | Medical Wellness Practice Pllc | Orthopaedic Surgery | 554 Tompkins Ave, Staten Island, NY 10305-1745 | 2020-11-03 |
| 1235691379 | Sny Care of Ny, LLC | Orthopaedic Surgery | 1131 Route 55 Ste 1a, Lagrangeville, NY 12540-5054 | 2019-04-05 |
| 1366903676 | Spine Health Orthopaedics PC | Orthopaedic Surgery | 110 Duane St, New York, NY 10007-1126 | 2019-03-28 |
| 1902388259 | Han Jo Kim Md PC | Orthopaedic Surgery | 541 E 71st St Fl 4, New York, NY 10021-4871 | 2018-09-04 |
| 1073011342 | Joint Replacement Cin of Manhattan LLC | Orthopaedic Surgery | 420 Lexington Ave Rm 300, New York, NY 10170-0399 | 2018-01-31 |
| 1871001750 | Spine Cin of Buffalo LLC | Orthopaedic Surgery | 3725a Walden Ave, Lancaster, NY 14086-1405 | 2018-01-13 |
| 1972011856 | Spine Cin of Hudson Valley LLC | Orthopaedic Surgery | 1131 Route 55 # 1a, Lagrangeville, NY 12540-5054 | 2018-01-13 |
| 1699283572 | Joint Replacement Cin of Hudson Valley LLC | Orthopaedic Surgery | 1131 Route 55 # 1b, Lagrangeville, NY 12540-5054 | 2018-01-13 |
| 1780071548 | Island Musculoskeletal Care Md PC | Orthopaedic Surgery | 10825 Jamaica Ave, Richmond Hill, NY 11418-2243 | 2015-04-20 |
| 1578990669 | Joseph Sae Hyun Pyun | Orthopaedic Surgery | 506 5th Ave, #2ff, Brooklyn, NY 11215-4812 | 2013-10-03 |
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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.