Provider Demographics
NPI:1932266475
Name:OB/GYN ASSOCIATES OF CENTRAL NEW YORK, P.C.
Entity Type:Organization
Organization Name:OB/GYN ASSOCIATES OF CENTRAL NEW YORK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAPANDREA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-724-6787
Mailing Address - Street 1:3 PARKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5643
Mailing Address - Country:US
Mailing Address - Phone:315-724-6787
Mailing Address - Fax:315-735-6624
Practice Address - Street 1:3 PARKSIDE CT
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5643
Practice Address - Country:US
Practice Address - Phone:315-724-6787
Practice Address - Fax:315-735-6624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01859549Medicaid
NY01859549Medicaid