Organization
SOUTHERN TIER EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN MANGANARO M.D. (PRESIDENT)
(607) 733-6541
Entity
Organization
Contact information
Practice address
555 E MARKET ST, ELMIRA, NY 14901-3223
(607) 733-6541
(607) 737-2624
Mailing address
111 E 14TH ST, ELMIRA HEIGHTS, NY 14903-1303
(607) 734-9539
(607) 734-6293
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01358209
—
NY
Enumeration date
08/09/2006
Last updated
08/22/2020
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