Provider Demographics
NPI:1083666895
Name:BINKLEY, DALE L (RPAC)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:L
Last Name:BINKLEY
Suffix:
Gender:M
Credentials:RPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:518-284-2333
Mailing Address - Fax:518-284-2245
Practice Address - Street 1:519 STATE HIGHWAY 20
Practice Address - Street 2:STE 1
Practice Address - City:SHARON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:13459
Practice Address - Country:US
Practice Address - Phone:518-284-2223
Practice Address - Fax:518-284-2445
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003293363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02259483Medicaid
NYS69087Medicare UPIN
NYCC9415Medicare ID - Type UnspecifiedUPSTATE