Provider Demographics
NPI:1861599169
Name:UNIVERSITY HOSPITAL PHYSICIANS
Entity type:Organization
Organization Name:UNIVERSITY HOSPITAL PHYSICIANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADULT NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SEYMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NP
Authorized Official - Phone:315-361-1041
Mailing Address - Street 1:603 SENECA ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2653
Mailing Address - Country:US
Mailing Address - Phone:315-361-1041
Mailing Address - Fax:315-361-1044
Practice Address - Street 1:603 SENECA ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2653
Practice Address - Country:US
Practice Address - Phone:315-361-1041
Practice Address - Fax:315-361-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300426-1261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF300426-1OtherSTATE NP LICENSE NUMBER
NM02552867Medicaid
NM02552867Medicaid
NM02552867Medicaid