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Organization
VISTA MEDICAL SERVICES, PC
Active
Organization
VISTA MEDICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. E. LANCE COBURN MD (OWNER)
(212) 410-4400
Entity
Organization
Contact information
Practice address
26 FIREMENS MEMORIAL DR STE 115, POMONA, NY 10970-3569
(845) 362-8400
Mailing address
1990 LEXINGTON AVE, NEW YORK, NY 10035-2902
(212) 410-4400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
198832
NY
Other
Enumeration date
04/27/2011
Last updated
04/27/2011
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