# PAULA PONS PHYSICIAN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033154364
- **Authorized official:** PAULA PONS M.D. (PRESIDENT)
- **Authorized official phone:** (315) 329-7003

## Contact information

- **Practice address:** 4206 MEDICAL CENTER DR STE 203, FAYETTEVILLE, NY 13066
- **Practice address phone:** (315) 329-7770
- **Mailing address:** 5413 SPRINGVIEW DRIVE, FAYETTEVILLE, NY 13066
- **Mailing address phone:** (315) 634-2003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 227287 | NY | Yes |

## Other

- **Enumeration date:** 06/19/2006
- **Last updated:** 10/23/2007