# JILL M LAUREANO SURBER DO PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY MEDICINE OF NORTHERN NEW YORK
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992112387
- **Authorized official:** DR. JILL LAUREANO-SURBER DO (OWNER)
- **Authorized official phone:** (315) 755-2560

## Contact information

- **Practice address:** 20053 SUMMIT VIEW BLVD STE 1, WATERTOWN, NY 13601-2170
- **Practice address phone:** (315) 755-2560
- **Practice address fax:** (315) 755-2597
- **Mailing address:** 20053 SUMMIT VIEW BLVD STE 1, WATERTOWN, NY 13601-2170
- **Mailing address phone:** (315) 755-2560
- **Mailing address fax:** (315) 755-2597

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 271910 | NY | Yes |

## Other

- **Enumeration date:** 07/17/2014
- **Last updated:** 01/12/2024