Healthcare Provider Details

I. General information

NPI: 1528379773
Provider Name (Legal Business Name): PAMELA F. HOBART NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N MAIN ST STE 203 GENEVA GENERAL SURGICAL ASSOCIATES
GENEVA NY
14456-2365
US

IV. Provider business mailing address

200 N MAIN ST STE 203 GENEVA GENERAL SURGICAL ASSOCIATES
GENEVA NY
14456-2365
US

V. Phone/Fax

Practice location:
  • Phone: 315-787-5383
  • Fax:
Mailing address:
  • Phone: 315-787-5383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF3053991
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: