Healthcare Provider Details

I. General information

NPI: 1396789418
Provider Name (Legal Business Name): BROOME COUNTY HEALTH DEPARTMENT-EI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 FRONT ST
BINGHAMTON NY
13905-2424
US

IV. Provider business mailing address

225 FRONT ST
BINGHAMTON NY
13905-2424
US

V. Phone/Fax

Practice location:
  • Phone: 607-778-2851
  • Fax: 607-778-2864
Mailing address:
  • Phone: 607-778-2851
  • Fax: 607-778-2864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA A. EDWARDS
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: M.S.
Phone: 607-778-2802