Organization
OUR LADY OF LOURDES HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA L WILVCZEK DPM (RESIDENT)
(315) 368-4206
Entity
Organization
Contact information
Practice address
169 RIVERSIDE DR, BINGHAMTON, NY 13905-4246
(607) 798-5111
Mailing address
10 ROTARY AVE, BINGHAMTON, NY 13905-4181
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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