Broome Surgery & Breast Care, P.C.

LBN: Broome Surgery & Breast Care, P.C.
Broome Surgery & Breast Care, P.C. is an health care organization with primary practice located at 240 Riverside Dr Suite 3, Johnson City NY 13790-2732. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Broome Surgery & Breast Care, P.C. can be contacted via phone (607) 729-0443, or through Mangouri, Ghassem via phone (607) 729-0443.

Contact Information

Primary practice address
240 Riverside Dr Suite 3 Johnson City NY 13790-2732
Phone: (607) 729-0443
Fax: (607) 766-9395
Website:
Map and Directions
Authorized official contact:
Name: Mangouri, Ghassem Doctor of Medicine (MD)
Phone: (607) 729-0443

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0154223 New York

Profile Details

NPI number 1790960839
LBN Legal business name Broome Surgery & Breast Care, P.C.
DBA Doing business as
Authorized official Mangouri, Ghassem Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 8th, 2008
Last updated Feb 7th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790960839 NPPES
New York MEDICAID 00775599

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