MEDICARE: ADVANTAGEHEALTH MEDICAL SERVICES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician
2	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1558342477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGEHEALTH MEDICAL SERVICES, PC

Provider Business Mailing Address
First Line	:	571 E MARKET ST
Second Line	:	SUITE 307
City	:	ELMIRA
State	:	NY
Zip	:	14901-3230
Country	:	US
Telephone Number	:	607-733-4659
Fax Number	:	607-733-4650

Provider Business Practice Location Address
First Line	:	571 E MARKET ST
Second Line	:	SUITE 307
City	:	ELMIRA
State	:	NY
Zip	:	14901-3230
Country	:	US
Telephone Number	:	607-733-4659
Fax Number	:	607-733-4650

Authorized Official
Title or Position	:	CONSULTANT
Name	:	MR. DONALD J VANGORDER
Credential	:
Telephone Number	:	607-737-1509

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	09/11/2025

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