Organization
IVAN G PROANO MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN G. PROANO MD (OWNER)
(315) 342-6176
Entity
Organization
Contact information
Practice address
15 BRONSON ST, OSWEGO, NY 13126-1004
(315) 342-6176
(315) 342-3120
Mailing address
15 BRONSON ST, OSWEGO, NY 13126-1004
(315) 342-6176
(315) 342-3120
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
00000000
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02258024
—
NY
Enumeration date
07/06/2006
Last updated
06/12/2013
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