| Jill M Laureano Surber Do Pc | |
|
20053 Summit View Blvd Ste 1 Watertown NY 13601-2170 | |
| (315) 755-2560 | |
| (315) 755-2597 |
| Full Name | Jill M Laureano Surber Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 20053 Summit View Blvd Ste 1, Watertown, New York |
| Authorized Official Name and Position | Jill Laureano-surber (OWNER) |
| Authorized Official Contact | 3157552560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill M Laureano Surber Do Pc 20053 Summit View Blvd Ste 1 Watertown NY 13601-2170 Ph: (315) 755-2560 | Jill M Laureano Surber Do Pc 20053 Summit View Blvd Ste 1 Watertown NY 13601-2170 Ph: (315) 755-2560 |
| NPI Number | 1992112387 |
|---|---|
| Provider Enumeration Date | 07/17/2014 |
| Last Update Date | 01/12/2024 |
| Medicare PECOS PAC ID | 9335463405 |
|---|---|
| Medicare Enrollment ID | O20150120001245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992112387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 271910 (New York) | Primary |
| Provider Name | Jill M Laureano-surber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437443132 PECOS PAC ID: 9133342892 Enrollment ID: I20140527001276 |
| Provider Name | Jennifer J Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144616962 PECOS PAC ID: 8628399458 Enrollment ID: I20150605000616 |
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