Basic Information
Provider Information
NPI: 1346506086
EntityType: 2
ReplacementNPI:  
OrganizationName: AURELIA OSBORN FOX MEMORIAL HOSPITAL-ONEONTA FAMILY
LastName:  
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Mailing Information
Address1: 1 NORTON AVE
Address2:  
City: ONEONTA
State: NY
PostalCode: 138202629
CountryCode: US
TelephoneNumber: 6074322000
FaxNumber:  
Practice Location
Address1: 1 FOXCARE DR
Address2:  
City: ONEONTA
State: NY
PostalCode: 138202099
CountryCode: US
TelephoneNumber: 6074321163
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2012
LastUpdateDate: 09/13/2019
NPIDeactivationReasonCode:  
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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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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X150423NYN193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 
261QR1300X  Y Ambulatory Health Care FacilitiesClinic/CenterRural Health

No ID Information.


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