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Organization

BIG FLATS PRIMARY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL PETER POVANDA D.O. (STAFF PHYSICIAN)
(607) 562-3000
Entity
Organization

Contact information

Practice address
455 MAPLE ST, SUITE 3, BIG FLATS, NY 14814-9701
(607) 562-3600
(607) 562-8661
Mailing address
455 MAPLE ST, SUITE 3, BIG FLATS, NY 14814-9701
(607) 562-3600
(607) 562-8661

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
195749
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00363126
NY
Enumeration date
08/31/2006
Last updated
07/16/2008
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