| Practitioner Services Of The Southern Tier | |
|
739 Larchmont Rd Elmira NY 14905-1216 | |
| (607) 734-8039 | |
| Not Available |
| Full Name | Practitioner Services Of The Southern Tier |
|---|---|
| Speciality | Internal Medicine |
| Location | 739 Larchmont Rd, Elmira, New York |
| Authorized Official Name and Position | Mary Johanna Foster (PRESIDENT) |
| Authorized Official Contact | 6077348039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Practitioner Services Of The Southern Tier 739 Larchmont Rd Elmira NY 14905-1216 Ph: (607) 734-8039 | Practitioner Services Of The Southern Tier 739 Larchmont Rd Elmira NY 14905-1216 Ph: (607) 734-8039 |
| NPI Number | 1427231919 |
|---|---|
| Provider Enumeration Date | 12/07/2007 |
| Last Update Date | 07/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427231919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 206255 (New York) | Primary |
| 363L00000X | Nurse Practitioner | 331091 (New York) | Secondary |
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