Individual
DR. ELLEN M LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
140 BROAD ST, HAMILTON, NY 13346-9575
(315) 228-7750
(315) 228-6823
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(315) 825-3111
(315) 825-3017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
217285
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02194558
—
NY
Enumeration date
05/15/2006
Last updated
11/27/2023
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