Basic Information
| Provider Information | |||||||||
| NPI: | 1295091312 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AURELIA OSBORN FOX MEMORIAL HOSPITAL STAMFORD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 NORTON AVE | ||||||||
| Address2: | |||||||||
| City: | ONEONTA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138202629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6074322000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 32-34 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | STAMFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121671171 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6076522000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2012 | ||||||||
| LastUpdateDate: | 09/13/2019 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | TRACEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | STAFF ACCOUNTANT | ||||||||
| AuthorizedOfficialTelephone: | 6074315305 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | AURELIA OSBORN FOX MEMORIAL HOSPITAL | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 234237 | NY | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.