Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 205518 | NY |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 205518 | NY |
NPI | 1629034285 |
---|---|
Provider Name | Dr. Mary Edith Obear |
First Address | Corfu, NY 14036-9753 |
Second Address | Corfu, NY 14036-9753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 04/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01909273 | (05) | NY |
G75804 | (02) | NY |