Southern Tier Obstetrics & Gynecology PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2172551 Issued in NY

Legal business name

SOUTHERN TIER OBSTETRICS & GYNECOLOGY PC

Practice address

242 N Union St
Olean, NY 14760

Phone

(716) 372-2770

Fax

(716) 372-2740

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Frank K Kwakye Berko, MD

Title

MD

Phone

(716) 372-2770

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609941103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 564",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "14760",
            "telephone_number": "716-372-2770",
            "fax_number": "716-372-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 N UNION ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "14760",
            "telephone_number": "716-372-2770",
            "fax_number": "716-372-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER OBSTETRICS & GYNECOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KWAKYE BERKO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "716-372-2770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "2172551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02107880",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian South, PSYD
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• Tony Eugene Sowers, LCSW
• Deveon L Spaeth
• Christopher Speta, LPN

• All providers in Olean, NY
• Obstetrics & Gynecology Physician in New York

• 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.