Organization Active NPI

Michele a Pavillard D.O.

  • Psychiatry Physician
  • Corning, NY
National Provider Identifier
1134130487
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MICHELE A PAVILLARD D.O.
Practice address
290 E 1St St
Suite 1
Corning, NY 14830-2925
Phone
(607) 936-1244
Fax
(607) 936-4023
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michele A Pavillard, D.O.
Title
D.O.
Phone
(607) 936-1244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

290 E 1St St
Suite 1
Corning, NY 14830-2925

Mailing address

111 E 14TH St
Elmira Heights, NY 14903-1303
Phone (607) 734-9539

National Provider Directory

National Provider Directory

Locations

290 E 1st St
Ste 1
Corning, NY 14830
Phone (607) 936-1244

290 E 1st St
Corning, NY 14830
Phone (607) 725-2389

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134130487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 14TH ST",
            "city": "ELMIRA HEIGHTS",
            "state": "NY",
            "postal_code": "149031303",
            "telephone_number": "607-734-9539",
            "fax_number": "607-734-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 E 1ST ST",
            "address_2": "SUITE 1",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302925",
            "telephone_number": "607-936-1244",
            "fax_number": "607-936-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELE A PAVILLARD D.O.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAVILLARD",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "D.O.",
        "authorized_official_telephone_number": "607-936-1244",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corning, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.