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General NPI Number Information
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NPI Number | 1831294537
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Entity Type | Organization
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Legal Business Name | ADVANCED WOMEN'S HEALTHCARE IN OBSTETRICS & GYNECOLOGY PLLC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 8 BROAD ST
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City | PLATTSBURGH
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State | NY
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Zip | 12901-3420
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Country | US
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Telephone | 518-563-8880
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Fax | 518-562-1077
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Provider Business Mailing Address
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Address Line | 8 BROAD ST
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City | PLATTSBURGH
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State | NY
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Zip | 12901-3420
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Country | US
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Telephone | 518-563-8880
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Fax | 518-562-1077
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JESSICA L SOULE
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Credential |
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Telephone | 518-561-2216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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