Provider Demographics
NPI:1164479903
Name:REGIONAL RHEUMATOLOGY ASSOCIATES LLP
Entity Type:Organization
Organization Name:REGIONAL RHEUMATOLOGY ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:OVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-798-5902
Mailing Address - Street 1:161 RIVERSIDE DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4176
Mailing Address - Country:US
Mailing Address - Phone:607-798-1842
Mailing Address - Fax:607-729-0147
Practice Address - Street 1:161 RIVERSIDE DR
Practice Address - Street 2:SUITE 302
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4176
Practice Address - Country:US
Practice Address - Phone:607-798-1842
Practice Address - Fax:607-729-0147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55105AMedicare PIN