Dr Lisa Koehl Mooney, MD | |
125 Main St, Oneonta, NY 13820-2531 | |
(607) 433-1792 | |
(607) 433-6608 |
Full Name | Dr Lisa Koehl Mooney |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 125 Main St, Oneonta, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619933058 | NPI | - | NPPES |
01761971 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 207806 (New York) | Primary |
Entity Name | Mary Imogene Bassett Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083664221 PECOS PAC ID: 3779488325 Enrollment ID: O20031205000553 |
Mailing Address | Practice Location Address |
---|---|
Dr Lisa Koehl Mooney, MD Po Box 725, Cooperstown, NY 13326-0725 Ph: (607) 433-1792 | Dr Lisa Koehl Mooney, MD 125 Main St, Oneonta, NY 13820-2531 Ph: (607) 433-1792 |
Abiodun Oyebola, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Norton Ave, Oneonta, NY 13820 Phone: 607-432-5600 | |
Kenneth G Lucas, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 179 River St, Oneonta, NY 13820 Phone: 607-433-3484 Fax: 607-432-5790 | |
Elizabeth Blasco, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 125 Main St, Oneonta, NY 13820 Phone: 607-433-1792 Fax: 607-433-6519 | |
Dr. Bridget Abieyuwa Igbinosun, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 125 Main St, Oneonta, NY 13820 Phone: 607-433-1790 Fax: 607-433-6608 | |
Dr. Nicholas W Tarricone, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 179 River St, Oneonta, NY 13820 Phone: 607-433-3484 Fax: 607-432-5790 | |
Dr. William J Fredette, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Norton Ave, Oneonta, NY 13820 Phone: 607-432-5600 |