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General NPI Number Information
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NPI Number | 1568679520
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Entity Type | Organization
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Legal Business Name | BINGHAMTON UNIVERSITY HEALTH SERVICES
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4400 VESTAL PARKWAY EAST BINGHAMTON UNIVERSITY HEALTH SERVICES
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City | BINGHAMTON
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State | NY
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Zip | 13902-6000
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Country | US
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Telephone | 607-777-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 2064 COUNTY ROAD 32
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City | GREENE
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State | NY
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Zip | 13778-2338
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL LEONARD
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Credential | M.D.
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Telephone | 607-777-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | 179170
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License Number State | NY
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