1134148570 NPI number — COUNTY OF CATTARAUGUS

Table of content: (NPI 1134148570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134148570 NPI number — COUNTY OF CATTARAUGUS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF CATTARAUGUS
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:
1134148570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 LEO MOSS DR
Provider Second Line Business Mailing Address:
SUITE 4010
Provider Business Mailing Address City Name:
OLEAN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14760-1100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-373-8050
Provider Business Mailing Address Fax Number:
716-701-3737

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LEO MOSS DR
Provider Second Line Business Practice Location Address:
SUITE 4010
Provider Business Practice Location Address City Name:
OLEAN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14760-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-701-3382
Provider Business Practice Location Address Fax Number:
716-701-3737
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WATKINS
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PUBLIC HEALTH DIRECTOR
Authorized Official Telephone Number:
716-701-3398

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  0401200R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00030716901 . This is a "UNIVERA - FP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000560763001 . This is a "BC/BS - GRACZYK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 8390018 . This is a "IH - CLINIC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9512666 . This is a "IH- MCANDREW" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9512632 . This is a "IH - GRACZYK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00474777 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00011208901 . This is a "UNIVERA - CLINIC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000512768001 . This is a "BC/BS - CLINIC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000560783001 . This is a "BC/BS - MCANDREW" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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