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1801 State Route 17c Owego NY 13827-3900 | |
(607) 751-3883 | |
(607) 751-6245 |
Full Name | |
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Speciality | Clinic/center |
Location | 1801 State Route 17c, Owego, New York |
Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | 1801 State Route 17c Owego NY 13827-3900 Ph: (607) 751-3883 |
NPI Number | 1710406939 |
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Provider Enumeration Date | 09/19/2017 |
Last Update Date | 08/16/2022 |
Identifier | Type | State | Issuer |
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1710406939 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Keith A Nichols Md, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 130 Temple St, Suite 100, Owego, NY 13827 Phone: 607-687-5616 | |