Basic Information
| Provider Information | |||||||||
| NPI: | 1174631782 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALBRIGHT | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | BURTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 251 SALINA MEADOWS PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132124516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154642000 | ||||||||
| FaxNumber: | 3154642010 | ||||||||
| Practice Location | |||||||||
| Address1: | 750 EAST ADAMS ST | ||||||||
| Address2: | |||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154641800 | ||||||||
| FaxNumber: | 3154646238 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 03/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | A96750 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 35272 | IA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | ME96547 | FL | N | Allopathic & Osteopathic Physicians | Surgery | 208C00000X | A96750 | CA | N | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | 208C00000X | 35272 | IA | N | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | 208C00000X | ME96547 | FL | N | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | 208C00000X | 290382 | NY | N | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | 208600000X | 290382 | NY | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 04872157 | 05 | NY | MEDICAID |