=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164428983
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASSOCIATES IN OBSTETRICS & GYNECOLOGY, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2005
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 DEGRANDPRE WAY
-----------------------------------------------------
City | PLATTSBURGH
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12901-6449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-563-3260
-----------------------------------------------------
Fax | 518-561-2877
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 DEGRANDPRE WAY
-----------------------------------------------------
City | PLATTSBURGH
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12901-6449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-563-3260
-----------------------------------------------------
Fax | 518-561-2877
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SUSAN A RECH
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 518-563-3260
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------