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Individual

MR. CLAY J VANDOREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
134 HOMER AVE, CORTLAND, NY 13045-1206
(607) 428-5074
(607) 428-5077
Mailing address
134 HOMER AVE, CORTLAND, NY 13045-1206
(607) 428-5074
(607) 428-5077

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
194911-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01821916
NY
Enumeration date
07/24/2006
Last updated
06/18/2010
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