Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 87 W. Main St., Dryden, New York |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093049611 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 70 011737 (New York) | Secondary |
111N00000X | Chiropractor | 70 011401 (New York) | Primary |
Provider Name | Sybil A Coburn |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1306929682 PECOS PAC ID: 6305015165 Enrollment ID: I20110811000674 |
Mailing Address | Practice Location Address |
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Po Box 1153, Dryden, NY 13053-1153 Ph: (607) 844-3304 | 87 W. Main St., Dryden, NY 13053 Ph: (607) 844-3304 |
Dr. Jason R Coburn, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 87 West Main St., Dryden, NY 13053 Phone: 607-283-1280 |