Individual
JAMES C HOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 HOOPER ROAD, ENDWELL FAMILY PHYSICIANS LLP, ENDWELL, NY 13760-3698
(607) 754-3863
(607) 754-5697
Mailing address
415 HOOPER RD, ENDWELL, NY 13760-3698
(607) 754-3863
(607) 754-5697
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
173413
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01357340
—
NY
01
—
10031727
CDPHP
—
01
—
4258763
AETNA
—
01
—
58142
GHI HMO
—
01
—
880592
AETNA HMO
—
01
—
88523
MVP SELECT
—
01
—
9599400
GHI
—
01
—
NY0043453
CHAMPUS
—
Enumeration date
07/20/2006
Last updated
07/08/2007
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