National Provider Identifier

Theresa Bodine, PA

Theresa Bodine, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Geneva, NY and a listed phone number of (315) 787-5100.

NPI 1780746487Geneva, NYPhysician Assistant

Profile Overview

NPI
1780746487
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
December 16, 2006
Last Updated
January 07, 2022

Practice Location

  • 200 North St
  • Geneva, NY 14456-1561

Phone: (315) 787-5100

Mailing Address

  • 571 Saint Josephs Blvd
  • Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Physician Assistant (363A00000X)

Endpoints

  • tbodine235144@direct.rochesterregional.org

    Direct Messaging Address | Direct | Geneva, NY 14456

Full Record
NPI
1780746487
Entity Type
Individual
Last Name
Bodine
First Name
Theresa
Credential
PA
Mailing Street Address
571 Saint Josephs Blvd
Mailing Address Line 2
Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2050
Mailing Fax
(607) 873-1244
Practice Street Address
200 North St
Practice City
Geneva
Practice State
NY
Practice ZIP Code
14456-1561
Practice Country
US
Practice Phone
(315) 787-5100
Practice Fax
(315) 787-5108
Enumeration Date
December 16, 2006
Last Updated
January 07, 2022
Sex
Female
Sole Proprietor
No
Certification Date
January 07, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
1793526 (NY), P0190044448 (NY, Blue Cross), 105524CK (NY, Preferred Care), P00003448 (NY, R.R. Medicare)