Healthcare Provider Details

I. General information

NPI: 1598973596
Provider Name (Legal Business Name): COUNTY OF ORANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 12/17/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MAIN STREET
GOSHEN NY
10924-2199
US

IV. Provider business mailing address

124 MAIN STREET
GOSHEN NY
10924-2199
US

V. Phone/Fax

Practice location:
  • Phone: 845-291-2332
  • Fax: 845-291-2341
Mailing address:
  • Phone: 845-291-2332
  • Fax: 845-291-2341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number3523600
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number3501200R
License Number StateNY

VIII. Authorized Official

Name: DR. JENNIFER L ROMAN
Title or Position: ACTING COMMISSIONER OF HEALTH
Credential: DO
Phone: 845-360-6600