Individual
TALLY EDWARD LASSITER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 ASSOCIATE DR, ONEONTA, NY 13820-2266
(607) 433-6314
(607) 433-6331
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(607) 433-6314
(607) 433-6331
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
256321
NY
Other
Enumeration date
09/25/2006
Last updated
06/12/2012
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