Healthcare Provider Details

I. General information

NPI: 1295897775
Provider Name (Legal Business Name): MR. DONALD E EMBLING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8-12 DIETZ ST
ONEONTA NY
13820-1849
US

IV. Provider business mailing address

PO BOX 298
OTEGO NY
13825-0298
US

V. Phone/Fax

Practice location:
  • Phone: 607-431-1030
  • Fax: 607-431-1033
Mailing address:
  • Phone: 607-287-0793
  • Fax: 607-431-1033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: