1841329737 NPI number — COUNTY OF ONEIDA

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 1841329737 NPI number — COUNTY OF ONEIDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF ONEIDA
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:
1841329737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
185 GENESEE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UTICA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13501-2102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-798-5080
Provider Business Mailing Address Fax Number:
315-798-5022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
406 ELIZABETH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UTICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13501-2306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-798-5747
Provider Business Practice Location Address Fax Number:
315-798-1057
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ENGLE
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
WILLIAM
Authorized Official Title or Position:
FSA
Authorized Official Telephone Number:
315-798-5080

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  127636-1 , 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: 00474171 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00081414 . This is a "PALMETTO GBA - RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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