CARMEN BAUTISTA-DATOR MD PC
Osteopathic Medicine at 4 St, Scriba, NY

License number
New York 2300280
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: DR. CARMEN BAUTISTA DATOR MD
Title: PHYSICIAN
Phone: (315) 343-2151
Address
Address
177 W 4Th St, Scriba, NY 13126
National Provider ID: 1912066242
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CARMEN BAUTISTA-DATOR, M.D., PC

71 Burden Dr, Oswego, NY 13126

Registration:
Mar 7, 2005
State ID:
3173562
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Carmen Bautista-Dator, 177 W 4 St, Oswego, NY 13126 (Physical)
Agent:
Esq Stephen H. Cohen,507 Plum St SUITE 300, Syracuse, NY 13204 (Physical)

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