Donnelly, Paul Thomas

Donnelly, Paul Thomas is an individual health care provider with primary practice located at 104 S Porter St , Watkins Glen NY 14891-1622. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Donnelly, Paul Thomas can be contacted via phone (607) 535-7873.

Contact Information

Primary practice address
104 S Porter St Watkins Glen NY 14891-1622
Phone: (607) 535-7873
Fax: (607) 535-7469
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 162852-1 New York

Profile Details

NPI number 1386672368
LBN Legal business name Donnelly, Paul Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jun 10th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386672368 NPPES
Other 080194958 RR MEDICARE
MEDICAID 01037172 RR MEDICARE

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