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General NPI Number Information
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NPI Number | 1841421278
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Entity Type | Organization
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Legal Business Name | PARADISE VETERINARY PRACTICE PC
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 4073 WARNER ROAD
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City | MARION
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State | NY
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Zip | 14505-9328
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Country | US
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Telephone | 315-926-5358
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Fax | 315-926-5359
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Provider Business Mailing Address
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Address Line | 4073 WARNER ROAD
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City | MARION
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State | NY
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Zip | 14505-9328
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Country | US
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Telephone | 315-926-5358
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Fax | 315-926-5359
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Authorized Official
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Title or Position | VETERINARIAN AND OWNER OF PARADISE
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Name | DR. DAVID FARLEY SCOVILLE
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Credential | DVM
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Telephone | 315-926-5358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 002884-1
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License Number State | NY
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