Most Relevant Information
Provider Data
| NPI Number: | 1003462375 |
| Provider Name: | JONATHAN MICHAEL FILLERS |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 402751 |
Most Important Dates
| Enumeration Date: | 08/13/2019 |
| Last Updated: | 08/13/2019 |
Provider Practice Location
1 ATWELL RD
COOPERSTOWN
NY
133261301
Practice Location Phone/Fax
| Phone: | 6075473456 |
| Fax: |
Provider Mailing Location
7 HASTINGS ST APT 1
BINGHAMTON
NY
139011616
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |