Individual
JONATHAN THOMAS GDOVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
65 PENNSYLVANIA AVE, BINGHAMTON, NY 13903
(607) 723-5393
(607) 771-0803
Mailing address
65 PENNSYLVANIA AVE, BINGHAMTON, NY 13903-1608
(607) 723-5393
(607) 771-0803
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
012857
NY
Other
Enumeration date
10/05/2008
Last updated
09/05/2012
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