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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1619979341 NPPES
New York MEDICAID 02461672

Popular Providers