Provider Demographics
NPI:1730195223
Name:THURBER & THURBER, DPM PC
Entity type:Organization
Organization Name:THURBER & THURBER, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:THURBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:607-734-4582
Mailing Address - Street 1:668 PARK PL
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2033
Mailing Address - Country:US
Mailing Address - Phone:607-734-4582
Mailing Address - Fax:607-734-4596
Practice Address - Street 1:668 PARK PL
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2033
Practice Address - Country:US
Practice Address - Phone:607-734-4582
Practice Address - Fax:607-734-4596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005738213E00000X
NYN005567-1213E00000X
PASC005555213E00000X
NYN003995-1213E00000X
PASC005739213E00000X
NYN003322-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50354BOtherDR. C. THURBER'S ME #
NY00743962Medicaid
NY50354COtherDR. T. THURBER'S ME #
NY00968901Medicaid
NY02082488Medicaid
NYBB5559OtherDR. D. PARK'S ME #
NY50354AMedicare PIN
480027984Medicare PIN
P00478658Medicare PIN
480017617Medicare PIN
NYBB5559OtherDR. D. PARK'S ME #
NY50354COtherDR. T. THURBER'S ME #
CF9161Medicare PIN
PA088466Medicare PIN