Provider Demographics
NPI:1659464758
Name:EXIGENCE MEDICAL OF BINGHAMTON PLLC
Entity Type:Organization
Organization Name:EXIGENCE MEDICAL OF BINGHAMTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEONA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-686-4316
Mailing Address - Street 1:307 S EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2739
Mailing Address - Country:US
Mailing Address - Phone:716-931-5595
Mailing Address - Fax:865-694-5113
Practice Address - Street 1:169 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4246
Practice Address - Country:US
Practice Address - Phone:607-798-5231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA0933Medicare UPIN