Organization
BROOME DEVELOPMENTAL SERVICES HIGH RISK BIRTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN LISHOK PSYCHOLOGIST (PSYCHOLOGIST III)
(607) 729-1295
Entity
Organization
Contact information
Practice address
305 MAIN ST, BINGHAMTON, NY 13905-2524
(607) 729-1295
Mailing address
305 MAIN ST, BINGHAMTON, NY 13905-2524
(607) 729-1295
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
NY
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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