Healthcare Provider Details

I. General information

NPI: 1013049873
Provider Name (Legal Business Name): HERKIMER COUNTY PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N WASHINGTON ST SUITE 2355
HERKIMER NY
13350-1216
US

IV. Provider business mailing address

301 N WASHINGTON ST SUITE 2355
HERKIMER NY
13350-1216
US

V. Phone/Fax

Practice location:
  • Phone: 315-867-1442
  • Fax: 315-867-1431
Mailing address:
  • Phone: 315-867-1442
  • Fax: 315-867-1431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY O'KEEFE
Title or Position: DIRECTOR OF PUBLIC HEALTH
Credential: M.D.
Phone: 315-867-1176