Individual
DR. CORI LEE MIKLOUCICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1130 UPPER FRONT ST, BINGHAMTON, NY 13905-1118
(607) 772-1995
Mailing address
1130 UPPER FRONT ST, BINGHAMTON, NY 13905-1118
(607) 772-1995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
244928
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03024531
—
NY
Enumeration date
06/10/2008
Last updated
02/25/2009
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