Healthcare Provider Details

I. General information

NPI: 1689663155
Provider Name (Legal Business Name): ESSEX COUNTY PUBLIC HEALTH NURSING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 WATER ST.
ELIZABETHTOWN NY
12932-0217
US

IV. Provider business mailing address

132 WATER STREET
ELIZABETHTOWN NY
12932-0217
US

V. Phone/Fax

Practice location:
  • Phone: 518-873-3500
  • Fax: 518-873-3539
Mailing address:
  • Phone: 518-873-3500
  • Fax: 518-873-3539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1521600
License Number StateNY

VIII. Authorized Official

Name: NAYEF DURHAM
Title or Position: OFFICE MANAGER
Credential:
Phone: 518-873-3503