Organization
OBSTETRIC AND GYNECOLOGIC ASSOC OF CORTLAND MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IN WHAN OH MD (PRESIDENT MD)
(607) 753-7578
Entity
Organization
Contact information
Practice address
11 ALVENA AVE, SUITE 101, CORTLAND, NY 13045
(607) 753-7578
(607) 758-3193
Mailing address
11 ALVENA AVE, SUITE 101, CORTLAND, NY 13045
(607) 753-7578
(607) 758-3193
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1472741
NY
207VG0400X
Gynecology Physician
1472741
NY
207VX0000X
Obstetrics Physician
1472741
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02288420
—
NY
01
—
33D0165489
CLIA
NY
Enumeration date
01/04/2007
Last updated
03/14/2013
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