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General NPI Number Information
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NPI Number | 1760318307
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Entity Type | Individual
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Provider Name | CODY JAMES PRINCE FNP
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Gender | Male
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | PO BOX 73
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City | ALFRED STATION
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State | NY
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Zip | 14803-0073
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Country | US
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Telephone | 607-590-6291
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 73
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City | ALFRED STATION
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State | NY
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Zip | 14803-0073
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Country | US
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Telephone | 607-590-6291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 358780
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License Number State | NY
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