1023147105 NPI number — CHENANGO COUNTY

Table of content: MRS. JENNIFER B. ARCANGEL-MATA BSN, RN, PHN (NPI 1174710297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023147105 NPI number — CHENANGO COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHENANGO COUNTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023147105
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 COURT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWICH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13815-1695
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-337-1660
Provider Business Mailing Address Fax Number:
607-337-1720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWICH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13815-1695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-337-1660
Provider Business Practice Location Address Fax Number:
607-337-1720
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FLINDT
Authorized Official First Name:
MARCAS
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PUBLIC HEALTH DIRECTOR
Authorized Official Telephone Number:
607-337-1660

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00474593 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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