Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 278543 | NY |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 278543 | NY |
NPI | 1225359532 |
---|---|
Provider Name | Justin Iorio |
First Address | East Syracuse, NY 13057-3072 |
Second Address | Syracuse, NY 13214-1985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2010 |
Last Update Date | 05/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04146425 | (05) | NY |