Individual
DR. AMY REBECCA COUSINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
149 VESTAL PARKWAY WEST, VESTAL, NY 13850
(607) 785-4171
(607) 785-3915
Mailing address
PO BOX 642, VESTAL, NY 13851-0642
(607) 785-4171
(607) 785-3915
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
137439
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00891070
—
NY
Enumeration date
10/02/2006
Last updated
07/08/2007
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