Individual
JAMES PAUL PEMBERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
134 HOMER AVENUE, CORTLAND, NY 13045
(607) 756-6571
(607) 756-1007
Mailing address
134 HOMER AVENUE, CORTLAND, NY 13045
(607) 756-6571
(607) 756-1007
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
193542
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01685230
—
NY
01
—
040426004397
FIDELIS
NY
01
—
361463
MVP
—
01
—
4221369
AETNA
—
Enumeration date
09/07/2006
Last updated
07/08/2007
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