Provider Demographics
NPI:1922170067
Name:THURBER AND THURBER, DPM PC
Entity Type:Organization
Organization Name:THURBER AND THURBER, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:607-565-8128
Mailing Address - Street 1:1 GARFIELD ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WAVERLY
Mailing Address - State:NY
Mailing Address - Zip Code:14892-1217
Mailing Address - Country:US
Mailing Address - Phone:607-565-8128
Mailing Address - Fax:607-565-8129
Practice Address - Street 1:1 GARFIELD ST
Practice Address - Street 2:SUITE 400
Practice Address - City:WAVERLY
Practice Address - State:NY
Practice Address - Zip Code:14892-1217
Practice Address - Country:US
Practice Address - Phone:607-565-8128
Practice Address - Fax:607-565-8129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003322-1332B00000X
NYN003995-1332B00000X
NYN005567-1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0947500003Medicare NSC