Organization
PAULA PONS PHYSICIAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA PONS M.D. (PRESIDENT)
(315) 329-7003
Entity
Organization
Contact information
Practice address
4206 MEDICAL CENTER DR STE 203, FAYETTEVILLE, NY 13066
(315) 329-7770
Mailing address
5413 SPRINGVIEW DRIVE, FAYETTEVILLE, NY 13066
(315) 634-2003
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
227287
NY
Other
Enumeration date
06/19/2006
Last updated
10/23/2007
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