Provider Demographics
NPI:1548312523
Name:MUSCULOSKELETAL MEDICINE P C
Entity type:Organization
Organization Name:MUSCULOSKELETAL MEDICINE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FINKENSTADT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-478-9710
Mailing Address - Street 1:475 IRVING AVE
Mailing Address - Street 2:STE 402
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1756
Mailing Address - Country:US
Mailing Address - Phone:315-478-9710
Mailing Address - Fax:315-479-9145
Practice Address - Street 1:475 IRVING AVE
Practice Address - Street 2:STE 402
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1756
Practice Address - Country:US
Practice Address - Phone:315-478-9710
Practice Address - Fax:315-479-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0857Medicare ID - Type UnspecifiedPROVIDER NUMBER