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Organization

RALPH EDWARD BOWMAN, PHYSICIAN PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JULIE CHUCKRAN (OFFICE MANAGER)
(845) 856-3323
Entity
Organization

Contact information

Practice address
170 E MAIN ST, PORT JERVIS, NY 12771-2220
(845) 856-3323
(845) 856-6107
Mailing address
170 E MAIN ST, PORT JERVIS, NY 12771-2220
(845) 856-3323
(845) 856-6107

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
167733
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01035116
NY
Enumeration date
01/03/2012
Last updated
01/03/2012
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