Basic Information
Provider Information
NPI: 1902800808
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PIPER
FirstName: JOHN
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2005
Address2:  
City: EAST SYRACUSE
State: NY
PostalCode: 130574505
CountryCode: US
TelephoneNumber: 3154490513
FaxNumber: 3154452936
Practice Location
Address1: 4900 BROAD RD
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132152265
CountryCode: US
TelephoneNumber: 3154925522
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/08/2005
LastUpdateDate: 05/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP2900X181164NYN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
207L00000X181164NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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