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Individual

ALAN T MIDURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
209 W STATE ST, ITHACA, NY 14850-5429
(607) 257-5263
(607) 216-0902
Mailing address
209 W STATE ST, ITHACA, NY 14850-5429
(607) 257-5263
(607) 216-0902

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
162420
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00898908
NY
Enumeration date
10/16/2006
Last updated
07/09/2007
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