1699730408 NPI number — ONONDAGA COUNTY COMPTROLLERS OFFICE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699730408 NPI number — ONONDAGA COUNTY COMPTROLLERS OFFICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONONDAGA COUNTY COMPTROLLERS OFFICE
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:
1699730408
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
421 MONTGOMERY ST
Provider Second Line Business Mailing Address:
JOHN H MULROY CIVIC CENTER
Provider Business Mailing Address City Name:
SYRACUSE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13202-2923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-435-2957
Provider Business Mailing Address Fax Number:
315-435-3590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
618 MADISON ST
Provider Second Line Business Practice Location Address:
CHILDREN AND FAMILY SERVICES OUTPATIENT CLINIC
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-435-7707
Provider Business Practice Location Address Fax Number:
315-435-7710
Provider Enumeration Date:
04/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORGAN
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CHIEF FISCAL OFFICER
Authorized Official Telephone Number:
315-435-3346

Provider Taxonomy Codes

  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 03004386 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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