Green, Gary Randall

Green, Gary Randall is an individual health care provider with primary practice located at 750 East Adams St , Syracuse NY 13210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Green, Gary Randall can be contacted via phone (315) 464-1800.

Contact Information

Primary practice address
750 East Adams St Syracuse NY 13210
Phone: (315) 464-1800
Fax: (315) 464-6238
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 224487 New York

Profile Details

NPI number 1780682336
LBN Legal business name Green, Gary Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780682336 NPPES
New York MEDICAID 02256848

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