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General NPI Number Information
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NPI Number | 1558342477
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Entity Type | Organization
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Legal Business Name | ADVANTAGEHEALTH MEDICAL SERVICES, PC
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 571 E MARKET ST SUITE 307
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City | ELMIRA
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State | NY
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Zip | 14901-3230
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Country | US
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Telephone | 607-733-4659
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Fax | 607-733-4650
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Provider Business Mailing Address
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Address Line | 571 E MARKET ST SUITE 307
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City | ELMIRA
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State | NY
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Zip | 14901-3230
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Country | US
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Telephone | 607-733-4659
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Fax | 607-733-4650
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Authorized Official
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Title or Position | CONSULTANT
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Name | MR. DONALD J VANGORDER
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Credential |
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Telephone | 607-737-1509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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