1295753788 NPI number — LIVINGSTON COUNTY CENTER FOR SEXUAL HEALTH AND WELLNESS

Table of content: (NPI 1295753788)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295753788 NPI number — LIVINGSTON COUNTY CENTER FOR SEXUAL HEALTH AND WELLNESS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIVINGSTON COUNTY CENTER FOR SEXUAL HEALTH AND WELLNESS
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:
LIVINGSTON COUNTY WOMEN'S HEALTH CENTER
Provider Other Organization Name Type Code:
5
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:
1295753788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 MURRAY HILL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT MORRIS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14510-1122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-243-7270
Provider Business Mailing Address Fax Number:
585-243-7287

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 MURRAY HILL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT MORRIS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14510-1122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-243-7270
Provider Business Practice Location Address Fax Number:
585-243-7287
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BURLEY
Authorized Official First Name:
JILL
Authorized Official Middle Name:
Authorized Official Title or Position:
DPS
Authorized Official Telephone Number:
585-243-7290

Provider Taxonomy Codes

  • Taxonomy code: 261QF0050X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00355248 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com