Healthcare Provider Details
I. General information
NPI: 1891728192
Provider Name (Legal Business Name): O'CONNOR HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
460 ANDES RD
DELHI NY
13753-7407
US
IV. Provider business mailing address
460 ANDES RD
DELHI NY
13753-7407
US
V. Phone/Fax
- Phone: 607-746-0326
- Fax: 607-746-0327
- Phone: 607-746-0326
- Fax: 607-746-0327
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | 1254700C |
| License Number State | NY |
VIII. Authorized Official
Name: MR.
DAN
AYERS
Title or Position: CEO
Credential:
Phone: 607-746-0326