Provider Demographics
NPI:1871290445
Name:UPSTATE ORTHOPEDICS, LLP
Entity type:Organization
Organization Name:UPSTATE ORTHOPEDICS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALBANESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-464-4472
Mailing Address - Street 1:6620 FLY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-4282
Mailing Address - Country:US
Mailing Address - Phone:315-464-8163
Mailing Address - Fax:315-464-5229
Practice Address - Street 1:208 TOWNSHIP BLVD
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-1786
Practice Address - Country:US
Practice Address - Phone:315-551-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies