Individual
JONATHAN R HOMUTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
302 HOFFMAN ST, ELMIRA, NY 14905-2263
(607) 734-2264
(607) 767-0340
Mailing address
302 HOFFMAN ST, ELMIRA, NY 14905-2263
(607) 734-2264
(607) 767-0340
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
111865
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00372647
—
NY
Enumeration date
06/14/2006
Last updated
07/08/2007
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