1285745349 NPI number — COUNTY OF GREENE

Table of content: (NPI 1285745349)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285745349 NPI number — COUNTY OF GREENE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF GREENE
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:
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:
1285745349
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
411 MAIN ST FL 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CATSKILL
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12414-1363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-719-3600
Provider Business Mailing Address Fax Number:
518-719-3799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 MAIN ST FL 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CATSKILL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12414-1363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-719-3600
Provider Business Practice Location Address Fax Number:
518-719-3799
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KAPLAN
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
INTERIM DIRECTOR OF PUBLIC HEALTH
Authorized Official Telephone Number:
518-719-3630

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  2169L001 , 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: 004394 . This is a "EMPIRE BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 114927 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P00475518 . This is a "MEDICARE B RR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000400508001 . This is a "BSNENY SR BLUE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 040401000521 . This is a "FIDELIS CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10002875-H874 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 56378 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 004394 . This is a "EMPIRE BC BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 03225096 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2283849 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: WZZYW1 . This is a "MEDICARE B" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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