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General NPI Number Information
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NPI Number | 1124790324
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Entity Type | Organization
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Legal Business Name | BIBY RAJAN-GEORGE M.D PLLC
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 4000 MEDICAL CENTER DRIVE
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City | FAYETTEVILLE
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State | NY
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Zip | 13066
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Country | US
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Telephone | 315-637-2665
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 MEDICAL CENTER DRIVE SUITE # 403
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City | FAYETTEVILLE
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State | NY
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Zip | 13066
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Country | US
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Telephone | 315-637-2665
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BIBY ELIZABETH RAJAN-GEORGE
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Credential | MD
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Telephone | 315-637-2665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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