Basic Information
| Provider Information | |||||||||
| NPI: | 1861563660 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SZABO | ||||||||
| FirstName: | ANDRAS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 134 HOMER AVE | ||||||||
| Address2: | PO BOX 627 | ||||||||
| City: | CORTLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077588019 | ||||||||
| FaxNumber: | 6077588210 | ||||||||
| Practice Location | |||||||||
| Address1: | 82 COPELAND AVE | ||||||||
| Address2: | |||||||||
| City: | HOMER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130771528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077531025 | ||||||||
| FaxNumber: | 6077531285 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 228299 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 02389926 | 05 | NY | MEDICAID |