Healthcare Provider Details

I. General information

NPI: 1235566100
Provider Name (Legal Business Name): HAMILTON MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2013
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 BROAD ST
HAMILTON NY
13346-9575
US

IV. Provider business mailing address

150 BROAD ST
HAMILTON NY
13346-9575
US

V. Phone/Fax

Practice location:
  • Phone: 315-824-6082
  • Fax:
Mailing address:
  • Phone: 315-824-6082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number210433
License Number StateNY

VIII. Authorized Official

Name: CARRIE BETH BOVA
Title or Position: EXECUTIVE DIRECTOR, BUSINESS
Credential:
Phone: 315-824-6560