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General NPI Number Information
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NPI Number | 1386900348
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Entity Type | Organization
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Legal Business Name | ELCOR OPERATING COMPANY LLC
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 04/04/2012
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Provider Practice Location Address
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Address Line | 48 COLONIAL DR
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City | HORSEHEADS
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State | NY
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Zip | 14845-8532
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Country | US
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Telephone | 607-739-3654
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Fax | 607-739-3213
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Provider Business Mailing Address
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Address Line | 48 COLONIAL DR
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City | HORSEHEADS
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State | NY
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Zip | 14845-8532
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Country | US
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Telephone | 607-739-3654
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Fax | 607-739-3213
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Authorized Official
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Title or Position | MEMBER
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Name | MR. ISRAEL SHERMAN
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Credential |
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Telephone | 607-739-3654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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