Healthcare Provider Details

I. General information

NPI: 1093362931
Provider Name (Legal Business Name): LITTLE FALLS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 BURWELL ST
LITTLE FALLS NY
13365-1716
US

IV. Provider business mailing address

140 BURWELL STREET
LITTLE FALLS NY
13365-1725
US

V. Phone/Fax

Practice location:
  • Phone: 315-823-4546
  • Fax: 315-843-4760
Mailing address:
  • Phone: 315-823-5281
  • Fax: 315-823-5383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES VIELKIND
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 315-823-5281