Provider Demographics
NPI:1275517716
Name:DOSS, MARY ELSIE (NP/PA)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELSIE
Last Name:DOSS
Suffix:
Gender:F
Credentials:NP/PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 RT. 38
Mailing Address - Street 2:P.O. BOX 68
Mailing Address - City:HARFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13784
Mailing Address - Country:US
Mailing Address - Phone:607-844-4707
Mailing Address - Fax:607-753-8422
Practice Address - Street 1:5 KENNEDY PKWY
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-1409
Practice Address - Country:US
Practice Address - Phone:607-753-8571
Practice Address - Fax:607-753-8422
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001091363A00000X
NYF330065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01271356Medicaid
NY000922511003OtherHEALTHNOW
NY01271356Medicaid
NYR56880Medicare UPIN