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MARY OBEAR MD PLLC NPI 1780698555


NPI Information

NPI: 1780698555
Provider Name: MARY OBEAR MD PLLC

Other Name: PEMBROKE FAMILY MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 33D0982966

Address:
860 MAIN ROAD
CORFU, NY
ZIP 14036
Phone: (585) 599-6446
Get Directions

MARY OBEAR MD PLLC is a family medicine in Corfu, NY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MARY OBEAR MD PLLC NPI is 1780698555. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Pembroke Family Medicine.

The provider's business location address is:

860 MAIN ROAD
CORFU, NY
ZIP 14036-753
Phone: (585) 599-6446
Fax: (585) 599-3166

The provider's authorized official is Mary E Obear .
The authorized official title is Owner and has the following contact phone number (585) 599-6446.

The CLIA number assigned to this NPI record is 33D0982966 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 11/16/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyNo
2207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
103044906MEDICAIDNEW YORK
2AA1316MEDICARE ID-TYPE UNSPECIFIEDNEW YORKMEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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