Provider Demographics
NPI:1154560381
Name:RICHARD D. SEMERAN M D PC
Entity type:Organization
Organization Name:RICHARD D. SEMERAN M D PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SEMERAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-474-7377
Mailing Address - Street 1:600 E GENESEE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3130
Mailing Address - Country:US
Mailing Address - Phone:315-474-7377
Mailing Address - Fax:315-474-5640
Practice Address - Street 1:600 E GENESEE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3130
Practice Address - Country:US
Practice Address - Phone:315-474-7377
Practice Address - Fax:315-474-5640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173039207V00000X
NY420080207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1265588958OtherNPI
NY1326147752OtherNPI
NYP38746Medicare UPIN
NYCC7897Medicare PIN
NYCC7898Medicare PIN
NY1265588958OtherNPI
NY1326147752Medicare UPIN
CC7898Medicare PIN