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General NPI Number Information
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NPI Number | 1982865309
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Entity Type | Organization
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Legal Business Name | THE VILLAGE NP
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 6 MAIN STREET, BOX 243
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City | WYOMING
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State | NY
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Zip | 14591-0243
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Country | US
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Telephone | 585-975-9180
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Fax |
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Provider Business Mailing Address
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Address Line | 6 MAIN STREET BOX 243
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City | WYOMING
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State | NY
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Zip | 14591-0243
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Country | US
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Telephone | 585-975-9180
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARAH M SCHAFER
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Credential | NP
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Telephone | 585-975-9180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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