IVY OBSTETRICS & GYNECOLOGY ASSOC PC (NPI# 1396763124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396763124 |
| Entity Type | Organization |
| Organization Name | IVY OBSTETRICS & GYNECOLOGY ASSOC PC |
| Practice Address |
600 Ivy St Elmira NY 14905-1627 |
| Practice Telephone | 6077344191 |
| Practice Fax Number | 6077340026 |
| Mailing Telephone | 6077344191 |
| Mailing Fax Number | 6077340026 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2008-07-22 |
| Authorized Official Name | DR. WALTER FREEMAN (PARTNER) |
| Authorized Official Telephone | 6077344191 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01345431 | 05 |
| Street Address |
600 IVY ST |
| City | ELMIRA |
| State | NY |
| Zip Code | 14905-1627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992797237 | Mark Terrance Metzdorff | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 600 Ivy St, Elmira, NY 14905-1627 | 2005-08-22 |
| 1457814535 | Mary Skiffey | Student in an Organized Health Care Education/Training Program | 600 Ivy St, Elmira, NY 14905-1627 | 2019-04-07 |
| 1306335625 | Noelani Arango Candelaria | Student in an Organized Health Care Education/Training Program | 600 Ivy St, Elmira, NY 14905-1627 | 2018-05-02 |
| 1447748777 | Rebecca John | Student in an Organized Health Care Education/Training Program | 600 Ivy St, Elmira, NY 14905-1627 | 2018-04-23 |
| 1972090900 | Ahmed Nour | Student in an Organized Health Care Education/Training Program | 600 Ivy St, Elmira, NY 14905-1627 | 2018-04-16 |
| 1538656616 | Manav Bandlamudi | Student in an Organized Health Care Education/Training Program | 600 Ivy St, Elmira, NY 14905-1627 | 2018-04-15 |
| 1558867911 | Cory I Baldwin | Student in an Organized Health Care Education/Training Program | 600 Ivy St, Elmira, NY 14905-1627 | 2018-04-04 |
| 1164928164 | Dan Alan Loughran | Student in an Organized Health Care Education/Training Program | 600 Ivy St, Elmira, NY 14905-1627 | 2018-03-30 |
| 1821593948 | Nimmy Simon | Student in an Organized Health Care Education/Training Program | 600 Ivy St, Elmira, NY 14905 | 2018-03-29 |
| 1184143919 | Ronald Lee Herman | Pharmacist | 600 Ivy St, Elmira, NY 14905-1627 | 2017-09-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780234146 | Theron Bennett | Technician | 900 West First Street, Elmira, NY 14905 | 2019-09-18 |
| 1558893792 | Zhezheng Li | Student in an Organized Health Care Education/Training Program | 600 Roe Street, Elmira, NY 14905 | 2017-03-28 |
| 1932555885 | Mitchell Pearce | Student in an Organized Health Care Education/Training Program | 602 Ivy Street, Elmira, NY 14905 | 2016-05-10 |
| 1982974465 | Chris Cook | Registered Nurse | 110 Hendy Ave, Elmira, NY 14905 | 2011-12-30 |
| 1578795290 | Richard Grinstead | Radiology | Arnot Ogden Medical Center, 600 Roe Ave, Elmira, NY 14905 | 2009-08-13 |
| 1033343967 | Janice Elaine Jackson | Registered Nurse | 1135 Hoffman Street, Elmira, NY 14905 | 2009-05-06 |
| 1598823361 | Obrien Hearing Aid Center | Hearing Aid Equipment | 227 Hoffman St, Elmira, NY 14905 | 2006-12-05 |
| 1487712634 | Robert Gordon Lyon | Dentist | 208 Walnut Street, Elmira, NY 14905 | 2006-12-04 |
| 1215009600 | Twin Tiers Dental Pllc | Dentist | 420 West Water St, Elmira, NY 14905 | 2006-11-14 |
| 1356432348 | Womens Health Services of Elmira | Obstetrics & Gynecology | 600 Fitch St Su 102, Elmira, NY 14905 | 2006-09-27 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356432348 | Womens Health Services of Elmira | Obstetrics & Gynecology | 600 Fitch St Su 102, Elmira, NY 14905 | 2006-09-27 |
| 1376895557 | Muna Tosnim Alam | Obstetrics & Gynecology | 600 Fitch St, Suite 102, Elmira, NY 14905-1634 | 2012-10-11 |
| 1023217148 | Christopher M Allen | Obstetrics & Gynecology | 1005 Walnut St., Elmira, NY 14901 | 2007-07-18 |
| 1427073816 | Walter J Freeman | Obstetrics & Gynecology | 600 Fitch St, Suite 102, Elmira, NY 14905-1634 | 2006-07-13 |
| 1720011414 | Kenneth Herzl-betz | Obstetrics & Gynecology | 600 Fitch St, Suite 102, Elmira, NY 14905-1634 | 2006-07-08 |
| 1245238674 | Sungji Chai | Obstetrics & Gynecology | 600 Fitch St, Suite 102, Elmira, NY 14905-1634 | 2005-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627799 | Kb Medical Practice PC | Obstetrics & Gynecology | 120 5th Ave Fl 5, New York, NY 10011-5638 | 2020-10-23 |
| 1780298281 | Tse Medical Pllc | Obstetrics & Gynecology | 846 55th Street, 1fl, Brooklyn, NY 11220-1122 | 2020-09-02 |
| 1285251108 | Khatri Medical Suites PC | Obstetrics & Gynecology | 466 Willis Avenue, Suite 366, Williston Park, NY 11596 | 2020-06-26 |
| 1891317582 | Lenox Obgyn, LLC | Obstetrics & Gynecology | 175 E 62nd St Ste 1a, New York, NY 10065-7626 | 2020-05-15 |
| 1750915062 | Radoslav Jovanovic, Md and Kevin Jovanovic, Md | Obstetrics & Gynecology | 930 Fifth Avenue, Suite 3, New York, NY 10021 | 2020-02-25 |
| 1508406901 | Jing Qiao Ob/gyn P.C. | Obstetrics & Gynecology | 4265 Kissena Blvd Unit L3, Flushing, NY 11355-3273 | 2020-01-14 |
| 1811531270 | Comprehensive Perinatal Medicine Pllc | Obstetrics & Gynecology | 13336 41st Rd # 2a, Flushing, NY 11355-3666 | 2019-10-29 |
| 1275176869 | Trustcare Women's Health Ob/gyn PC | Obstetrics & Gynecology | 730 58th St Bsmt, Brooklyn, NY 11220-3917 | 2019-10-25 |
| 1194379644 | Giovanna Fiorella Ramirez Barbieri | Obstetrics & Gynecology | 374 Stockholm St, Brooklyn, Ny 11237, Brooklyn, NY 11237 | 2019-08-01 |
| 1427610021 | K & K Broadway Inc. | Obstetrics & Gynecology | 111 Broadway Rm 1405, New York, NY 10006-3903 | 2019-07-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.