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46 Harrison St Johnson City NY 13790-2120 | |
| (607) 729-6531 | |
| (607) 217-0110 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 46 Harrison St, Johnson City, New York |
| Authorized Official Name and Position | Lenore Lynn Boris (PRACTICE PLAN MANAGER) |
| Authorized Official Contact | 6077723516 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
425 Robinson St Binghamton NY 13904-1735 Ph: (607) 772-3516 | 46 Harrison St Johnson City NY 13790-2120 Ph: (607) 729-6531 |
| NPI Number | 1265987325 |
|---|---|
| Provider Enumeration Date | 08/18/2016 |
| Last Update Date | 08/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265987325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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