| Ralph Edward Bowman, Physician PC | |
|
170 E Main St Port Jervis NY 12771-2220 | |
| (845) 856-3323 | |
| (845) 856-6107 |
| Full Name | Ralph Edward Bowman, Physician PC |
|---|---|
| Speciality | General Practice |
| Location | 170 E Main St, Port Jervis, New York |
| Authorized Official Name and Position | Julie Chuckran (OFFICE MANAGER) |
| Authorized Official Contact | 8458563323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ralph Edward Bowman, Physician PC 170 E Main St Port Jervis NY 12771-2220 Ph: (845) 856-3323 | Ralph Edward Bowman, Physician PC 170 E Main St Port Jervis NY 12771-2220 Ph: (845) 856-3323 |
| NPI Number | 1639449002 |
|---|---|
| Provider Enumeration Date | 01/03/2012 |
| Last Update Date | 01/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639449002 | NPI | - | NPPES |
| 01035116 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 167733 (New York) | Primary |
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