Healthcare Provider Details

I. General information

NPI: 1083742720
Provider Name (Legal Business Name): BROOME COUNTY HEALTH DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 03/06/2015
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: 607-778-2802
  • Fax:
Mailing address:
  • Phone: 607-778-2802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. CLAUDIA A EDWARDS
Title or Position: DIRECTOR OF PUBLIC HEALTH
Credential: MS
Phone: 607-778-2802