Individual
MISS EMILY GRACE DUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2174
(607) 763-6412
(607) 763-5854
Mailing address
33 LEWIS RD, 2ND FL, BINGHAMTON, NY 13905
(607) 729-8156
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
023239
NY
363AM0700X
Medical Physician Assistant
PA12502
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013972801
GROUP NPI
—
01
—
1326598814
NPI
—
Enumeration date
01/31/2019
Last updated
02/25/2019
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