Provider Demographics
NPI:1316935851
Name:CENTRAL NEW YORK INFUSION SERVICES LLC
Entity type:Organization
Organization Name:CENTRAL NEW YORK INFUSION SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:SADOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CRNI
Authorized Official - Phone:315-424-7027
Mailing Address - Street 1:333 BUTTERNUT DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1803
Mailing Address - Country:US
Mailing Address - Phone:315-424-7027
Mailing Address - Fax:315-424-7638
Practice Address - Street 1:333 BUTTERNUT DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-1803
Practice Address - Country:US
Practice Address - Phone:315-424-7027
Practice Address - Fax:315-424-7638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01978647Medicaid
NY3347576OtherNABP
NY01978647Medicaid