Healthcare Provider Details

I. General information

NPI: 1154433860
Provider Name (Legal Business Name): PINNACLE FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 ELM ST
HORNELL NY
14843-1933
US

IV. Provider business mailing address

7 SENECA ST C/O INTEGRA MEDICAL SERVICES
HORNELL NY
14843-1312
US

V. Phone/Fax

Practice location:
  • Phone: 607-281-1970
  • Fax: 607-281-1969
Mailing address:
  • Phone: 607-324-1372
  • Fax: 607-324-1374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: DENNIS CANTY
Title or Position: BUSINESS PARTNER
Credential:
Phone: 607-324-1372