Provider Demographics
NPI:1528314879
Name:SOUTHERN NEW YORK NEUROSURGICAL GROUP, P.C.
Entity type:Organization
Organization Name:SOUTHERN NEW YORK NEUROSURGICAL GROUP, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAEED
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAJWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-729-4942
Mailing Address - Street 1:46 HARRISON ST
Mailing Address - Street 2:P.O. BOX 910
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2120
Mailing Address - Country:US
Mailing Address - Phone:607-729-4942
Mailing Address - Fax:607-729-7516
Practice Address - Street 1:1000 E GENESEE ST
Practice Address - Street 2:SUITE 602
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1892
Practice Address - Country:US
Practice Address - Phone:315-475-3999
Practice Address - Fax:315-475-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty