Individual
REBECCA SUSAN PETTIBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
555 SAINT JOSEPHS BLVD STE M2, ELMIRA, NY 14901-3223
(607) 734-7121
(607) 734-0614
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
310746
NY
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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