Healthcare Provider Details

I. General information

NPI: 1972604460
Provider Name (Legal Business Name): MASSENA HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR
MASSENA NY
13662-1056
US

IV. Provider business mailing address

1 HOSPITAL DR
MASSENA NY
13662-1056
US

V. Phone/Fax

Practice location:
  • Phone: 315-769-4200
  • Fax: 315-769-4353
Mailing address:
  • Phone: 315-769-4200
  • Fax: 315-769-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAVID BENDER
Title or Position: CEO/AO
Credential:
Phone: 315-769-4200