Individual
LOIS-JEAN MARIE MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
76 VETERANS AVE, BATH, NY 14810-0810
(607) 664-4000
Mailing address
8450 TOWNLINE RD, WAYLAND, NY 14572-9332
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304991-1
NY
Other
Enumeration date
03/31/2009
Last updated
07/24/2009
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