Basic Information
Provider Information
NPI: 1871266338
EntityType: 2
ReplacementNPI:  
OrganizationName: HOSPITALIST SERVICES OF OLEAN P.C.
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Mailing Information
Address1: 6075 POPLAR AVE STE 401
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381190114
CountryCode: US
TelephoneNumber: 9017953600
FaxNumber: 9017956060
Practice Location
Address1: 515 MAIN ST
Address2:  
City: OLEAN
State: NY
PostalCode: 147601598
CountryCode: US
TelephoneNumber: 7163732600
FaxNumber: 9017956060
Other Information
ProviderEnumerationDate: 07/29/2021
LastUpdateDate: 07/29/2021
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: GLANTZ
AuthorizedOfficialFirstName: SANFORD
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AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 9017953600
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate: 07/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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