Otter Creek Medical Office, Llp | |
2 Elm St Mc Graw NY 13101-9471 | |
(607) 836-7540 | |
(607) 836-4180 |
Full Name | Otter Creek Medical Office, Llp |
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Speciality | Family Medicine |
Location | 2 Elm St, Mc Graw, New York |
Authorized Official Name and Position | Mary Therese Mastrucci (PARTNER) |
Authorized Official Contact | 6077560709 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Otter Creek Medical Office, Llp 2 Elm St Mc Graw NY 13101-9471 Ph: (607) 836-7540 | Otter Creek Medical Office, Llp 2 Elm St Mc Graw NY 13101-9471 Ph: (607) 836-7540 |
NPI Number | 1164478293 |
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Provider Enumeration Date | 05/26/2006 |
Last Update Date | 11/03/2008 |
Identifier | Type | State | Issuer |
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1164478293 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 186955 (New York) | Primary |
207Q00000X | Family Medicine | 000148 (New York) | Secondary |
208000000X | Pediatrics | 187190 (New York) | Secondary |