Individual
ANGELA K DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1138 BROADWAY ST, ELMIRA, NY 14904-2502
(607) 734-2695
(607) 734-2917
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015342
NY
363AS0400X
Surgical Physician Assistant
015342
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03436766
—
NY
Enumeration date
02/29/2012
Last updated
06/10/2016
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