Organization Active NPI

Internal Medicine Associates of the Southern Tier, PC

  • Clinical Medical Laboratory
  • Elmira, NY
National Provider Identifier
1457436065
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
INTERNAL MEDICINE ASSOCIATES OF THE SOUTHERN TIER, PC
Practice address
200 Madison Ave
Elmira, NY 14901-3218
Phone
(607) 734-1581
Fax
(607) 734-0972
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
David A. Frey
Title
Administrator
Phone
(607) 734-1581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NY Primary

Addresses

Primary practice location

200 Madison Ave
Elmira, NY 14901-3218

Mailing address

200 Madison Ave
Elmira, NY 14901-3218
Phone (607) 734-1581

Other names 1

  • Lab Other name

National Provider Directory

National Provider Directory

Locations

200 Madison Ave
Elmira, NY 14901
Phone (607) 734-1581

200 Madison Ave
Fl 3
Elmira, NY 14901
Phone (607) 734-1581

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1457436065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MADISON AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013218",
            "telephone_number": "607-734-1581",
            "fax_number": "607-734-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MADISON AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013218",
            "telephone_number": "607-734-1581",
            "fax_number": "607-734-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF THE SOUTHERN TIER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "607-734-1581"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.