Provider Demographics
NPI:1871558833
Name:VANRIPER, LOREN G (MD)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:G
Last Name:VANRIPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17 LANSING ST
Mailing Address - Street 2:AUBURN MEMORIAL MEDICAL SERVICES, PC
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1983
Mailing Address - Country:US
Mailing Address - Phone:315-255-7438
Mailing Address - Fax:315-255-7099
Practice Address - Street 1:143 NORTH ST
Practice Address - Street 2:SUITE #4
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1852
Practice Address - Country:US
Practice Address - Phone:315-252-5028
Practice Address - Fax:315-252-1587
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2268671207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02359873Medicaid
NY02359873Medicaid
E90376Medicare UPIN