Healthcare Provider Details

I. General information

NPI: 1003811449
Provider Name (Legal Business Name): COUNTY OF ULSTER NY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 GOLDEN HILL LN
KINGSTON NY
12401-6441
US

IV. Provider business mailing address

239 GOLDEN HILL LN
KINGSTON NY
12401-6441
US

V. Phone/Fax

Practice location:
  • Phone: 845-340-3070
  • Fax: 845-340-3086
Mailing address:
  • Phone: 845-340-3070
  • Fax: 845-340-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1874L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number5501201R
License Number StateNY

VIII. Authorized Official

Name: DR. CAROL M SMITH
Title or Position: COMMISSIONER OF HEALTH
Credential: MD, MPH
Phone: 845-340-3009