Provider Demographics
NPI:1861619835
Name:BINGHAMTON UNIVERSITY HEALTH SERVICES
Entity type:Organization
Organization Name:BINGHAMTON UNIVERSITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MS,APRN,BC,FNP
Authorized Official - Phone:607-777-2236
Mailing Address - Street 1:7 BROOK AVENUE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903
Mailing Address - Country:US
Mailing Address - Phone:607-722-3714
Mailing Address - Fax:
Practice Address - Street 1:4400 VESTAL PKWY, EAST
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850
Practice Address - Country:US
Practice Address - Phone:607-777-2236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331440261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health