Douglas Tucker, MD | |
100 Malta Ln, Syracuse, NY 13212-2375 | |
(315) 703-3586 | |
Not Available |
Full Name | Douglas Tucker |
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Gender | Male |
Speciality | Internal Medicine |
Location | 100 Malta Ln, Syracuse, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588093843 | NPI | - | NPPES |
1548366271 | Other | NY | CLINIC NPI |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | 168294 (New York) | Primary |
Entity Name | Loretto Rest Realty Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548366271 PECOS PAC ID: 3678560703 Enrollment ID: O20040429000502 |
Mailing Address | Practice Location Address |
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Douglas Tucker, MD 177 Lawrence Rd E, North Syracuse, NY 13212-3844 Ph: (315) 703-3586 | Douglas Tucker, MD 100 Malta Ln, Syracuse, NY 13212-2375 Ph: (315) 703-3586 |
Courtney Myers, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 750 E Adams St Ste 311, Syracuse, NY 13210 Phone: 315-464-5815 | |
Joan Marie Mitchell, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 736 Irving Ave, Syracuse, NY 13210 Phone: 315-425-4828 Fax: 315-425-4827 | |
Saverio J. Barbera, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 90 Presidential Plaza, Ste 5010, Syracuse, NY 13202 Phone: 315-464-9335 Fax: 315-464-9338 | |
Gordana Obradovic, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1304 Buckley Rd, Suite 200, Syracuse, NY 13212 Phone: 315-478-3311 Fax: 315-476-5211 | |
Kristin A Ramella, NP Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 90 Presidential Plz Ste 5010, Syracuse, NY 13202 Phone: 315-464-9335 | |
Vinodhini M Subramanian, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 736 Irving Ave, Syracuse, NY 13210 Phone: 315-470-7111 | |
Robert R. Michiel, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 90 Presidential Plz, 5th Floor, Syracuse, NY 13202 Phone: 315-464-9335 Fax: 315-464-9338 |