Basic Information
Provider Information
NPI: 1992784995
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANGANI
FirstName: GEETA
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 1001 W FAYETTE ST
Address2: STE 400
City: SYRACUSE
State: NY
PostalCode: 132042859
CountryCode: US
TelephoneNumber: 3154721488
FaxNumber: 3154728060
Practice Location
Address1: 191 INTREPID LN
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132052548
CountryCode: US
TelephoneNumber: 3154693373
FaxNumber: 3154698506
Other Information
ProviderEnumerationDate: 01/10/2006
LastUpdateDate: 02/18/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101X183137NYN Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
207R00000X183137NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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