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NPI Code Detail

MEDICARE: DR. MARY EDITH OBEAR MD PHD

MEDICARE: DR. MARY EDITH OBEAR MD PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician205518NY
2207QH0002XHospice and Palliative Medicine (Family Medicine) Physician205518NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629034285
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY EDITH OBEAR MD PHD
Provider Business Mailing Address
First Line : 860 MAIN RD
Second Line :
City : CORFU
State : NY
Zip : 14036-9753
Country : US
Telephone Number : 585-599-6446
Fax Number : 585-599-3166
Provider Business Practice Location Address
First Line : 860 MAIN RD
Second Line :
City : CORFU
State : NY
Zip : 14036-9753
Country : US
Telephone Number : 585-599-6446
Fax Number : 585-599-3166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2006
Last Update Date : 03/04/2013

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1013004654 — FRED A GABRIELE MS, FNP
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1619151560 — MRS. PEGGY S URBANCZYK RN
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