1487653853 NPI number — HERKIMER COUNTY

Table of content: KAY S. HASTINGS CRNA (NPI 1700834785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487653853 NPI number — HERKIMER COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HERKIMER 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:
1487653853
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 N WASHINGTON ST
Provider Second Line Business Mailing Address:
SUITE 2300
Provider Business Mailing Address City Name:
HERKIMER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13350-1299
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-867-1176
Provider Business Mailing Address Fax Number:
315-867-1262

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE 2300
Provider Business Practice Location Address City Name:
HERKIMER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13350-1299
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-867-1176
Provider Business Practice Location Address Fax Number:
315-867-1262
Provider Enumeration Date:
07/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
O'KEEFE
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PUBLIC HEALTH
Authorized Official Telephone Number:
315-867-1176

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  2124600 , 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: 00473712 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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