Healthcare Provider Details

I. General information

NPI: 1598767048
Provider Name (Legal Business Name): PAUL GERALD COMBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 ERIE BLVD. CANAJOHARIE HEALTH CENTER
CANAJOHARIE NY
13317-1133
US

IV. Provider business mailing address

48 ERIE BLVD. CANAJOHARIE HEALTH CENTER
CANAJOHARIE NY
13317-1133
US

V. Phone/Fax

Practice location:
  • Phone: 518-673-2573
  • Fax: 518-673-2781
Mailing address:
  • Phone: 518-673-2573
  • Fax: 518-673-2781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number214268-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: