Southern Tier Surgical PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

178438 Issued in NY

Legal business name

SOUTHERN TIER SURGICAL PLLC

Practice address

30 Harrison Street
Suite 320
Johnson City, NY 13790-2162

Phone

(607) 763-8205

Fax

(607) 763-8208

NPI assigned

Sep 6, 2012

Organization subpart

No

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

Authorized official

Name

Christian Tvetenstrand, M.D.

Title

Surgeon

Phone

(607) 763-8205

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1316296205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HARRISON STREET",
            "address_2": "SUITE 320",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902162",
            "telephone_number": "607-763-8205",
            "fax_number": "607-763-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HARRISON STREET",
            "address_2": "SUITE 320",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902162",
            "telephone_number": "607-763-8205",
            "fax_number": "607-763-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER SURGICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "TVETENSTRAND",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "607-763-8205",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "178438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Tier Family Nurse Practitioner Services
• Southern Tier Physical Therapy of Johnson City
• Southern Tier Pulmonary & Critical Care Medicine LLC
• Southern Tier Special Needs Resources LLC
• Southern Tier Surgery Center LLC
• Joshua Sowle, NP
• Jennifer Spalik
• Kara Spalik, N.P.
• Mark Paul Speicher, DO
• Ryan C Spencer, PT

• Surgery Physician in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; 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.