Healthcare Provider Details
I. General information
NPI: 1942379201
Provider Name (Legal Business Name): JAMES LOUIS PFEIFF
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2006
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
321 GENESEE ST ATTN: WOUND CARE
ONEIDA NY
13421
US
IV. Provider business mailing address
321 GENESEE ST
ONEIDA NY
13421-2611
US
V. Phone/Fax
- Phone: 315-361-2268
- Fax: 315-361-2968
- Phone: 315-361-2268
- Fax: 315-361-2968
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0011X |
| Taxonomy | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
L
PFEIFF
Title or Position: OWNER
Credential: MD
Phone: 315-363-9380