| Liberty Resources, Inc. | |
|
1045 James St Syracuse NY 13203-2758 | |
| (315) 425-1004 | |
| (315) 422-4855 |
| Full Name | Liberty Resources, Inc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1045 James St, Syracuse, New York |
| Authorized Official Name and Position | Carl M. Coyle (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3154251004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Resources, Inc. 1045 James St Syracuse NY 13203-2758 Ph: (315) 425-1004 | Liberty Resources, Inc. 1045 James St Syracuse NY 13203-2758 Ph: (315) 425-1004 |
| NPI Number | 1821485483 |
|---|---|
| Provider Enumeration Date | 04/22/2015 |
| Last Update Date | 11/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821485483 | NPI | - | NPPES |
| 04286357 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3301227R (New York) | Primary |
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