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General NPI Number Information
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NPI Number | 1518956176
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Entity Type | Organization
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Legal Business Name | BROOME ONCOLOGY LLC
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 01/21/2014
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Provider Practice Location Address
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Address Line | 30 HARRISON ST SUITE 100
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2161
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Country | US
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Telephone | 607-763-6850
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Fax | 607-763-6703
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Provider Business Mailing Address
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Address Line | 30 HARRISON ST SUITE 100
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2161
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Country | US
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Telephone | 607-763-6850
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Fax | 607-763-6703
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Authorized Official
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Title or Position | LEAD PHYSICIAN
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Name | MADHURI YALAMANCHILI
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Credential | M.D.
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Telephone | 607-763-6850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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