Basic Information
Provider Information
NPI: 1891078960
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORELLANA
FirstName: CESAR
MiddleName: EMILIANO
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 210 W DIVISION ST
Address2: APARTMENT 9
City: SYRACUSE
State: NY
PostalCode: 132041566
CountryCode: US
TelephoneNumber: 3157603001
FaxNumber:  
Practice Location
Address1: 750 E ADAMS ST
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132102342
CountryCode: US
TelephoneNumber: 3154645540
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/24/2011
LastUpdateDate: 09/24/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XASO552489567NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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