Canavan, Martin
Canavan, Martin is an individual health care provider with primary practice located at 4700 Onondaga Blvd , Syracuse NY 13219-3316. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Canavan, Martin can be contacted via phone (315) 475-7121.Contact Information
Primary practice address
4700 Onondaga Blvd
Syracuse NY 13219-3316
Phone: (315) 475-7121
Fax: (315) 475-7144
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 010239 | New York |
Profile Details
| NPI number | 1619979341 |
|---|---|
| LBN Legal business name | Canavan, Martin |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2005 |
| Last updated | May 13th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619979341 | NPPES |
| New York | MEDICAID | 02461672 |
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