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Organization

IVY OBSTETRICS & GYNECOLOGY ASSOC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WALTER FREEMAN M.D. (PARTNER)
(607) 734-4191
Entity
Organization

Contact information

Practice address
600 IVY ST, ELMIRA, NY 14905-1627
(607) 734-4191
(607) 734-0026
Mailing address
600 IVY ST, ELMIRA, NY 14905-1627
(607) 734-4191
(607) 734-0026

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01345431
NY
Enumeration date
07/18/2006
Last updated
07/22/2008
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