Individual
DR. GREGORY ASA MAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
74 BUNNER STREET, OSWEGO, NY 13126
(718) 960-6159
Mailing address
110 WEST 6TH STREET, OSWEGO, NY 13126
(718) 960-6159
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
156672-1
NY
2084P0800X
Psychiatry Physician
Primary
156672-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01822595
—
NY
Enumeration date
03/14/2006
Last updated
04/10/2015
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