Healthcare Provider Details

I. General information

NPI: 1285861740
Provider Name (Legal Business Name): AURELIA OSBORN FOX MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 NORTON AVE
ONEONTA NY
13820-2629
US

IV. Provider business mailing address

1 NORTON AVE
ONEONTA NY
13820-2629
US

V. Phone/Fax

Practice location:
  • Phone: 607-431-5305
  • Fax:
Mailing address:
  • Phone:
  • 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 Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK WRIGHT
Title or Position: CFO
Credential:
Phone: 607-431-5900