Individual
IVAN G. PROANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 BRONSON ST, OSWEGO, NY 13126-1004
(315) 342-6176
(315) 342-3120
Mailing address
15 BRONSON ST, OSWEGO, NY 13126-1004
(315) 342-6176
(315) 342-3120
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
187919
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01284784
—
NY
Enumeration date
07/06/2006
Last updated
12/19/2007
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