Individual
PAUL W TRAVERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 HARRISON ST, STE 250, JOHNSON CITY, NY 13790
(607) 770-8600
(607) 770-0853
Mailing address
30 HARRISON ST, STE 250, JOHNSON CITY, NY 13790
(607) 770-8600
(607) 770-0853
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
139286
NY
207RI0011X
Interventional Cardiology Physician
Primary
139286
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00766707
—
NY
Enumeration date
06/08/2006
Last updated
02/08/2011
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