Healthcare Provider Details

I. General information

NPI: 1972544237
Provider Name (Legal Business Name): HELENE CLAIRE LONGACRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HELENE CLAIRE LONGACRE-PRICE MD

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4417 VESTAL PKWY E
VESTAL NY
13850-3556
US

IV. Provider business mailing address

33 LEWIS RD 2ND FL
BINGHAMTON NY
13905
US

V. Phone/Fax

Practice location:
  • Phone: 607-797-4496
  • Fax: 607-729-5995
Mailing address:
  • Phone: 607-770-0025
  • Fax: 607-729-3982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number223913
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: