Basic Information
| Provider Information | |||||||||
| NPI: | 1720378342 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KLIMEK | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1904 GENESEE ST | ||||||||
| Address2: | |||||||||
| City: | UTICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 135025646 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 750 E ADAMS ST | ||||||||
| Address2: | |||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132102306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154645136 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2011 | ||||||||
| LastUpdateDate: | 11/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 276690-1 | NY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PS0010X | 276690 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Sports Medicine |
No ID Information.