Healthcare Provider Details

I. General information

NPI: 1376895953
Provider Name (Legal Business Name): PUTNAM COUNTY DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GENEVA RD
BREWSTER NY
10509-2339
US

IV. Provider business mailing address

1 GENEVA RD
BREWSTER NY
10509-2339
US

V. Phone/Fax

Practice location:
  • Phone: 845-808-1390
  • Fax: 845-278-7921
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number1342621
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL J NESHEIWAT
Title or Position: COMMISSIONER
Credential: M.D.
Phone: 845-808-1390