Healthcare Provider Details

I. General information

NPI: 1689074882
Provider Name (Legal Business Name): NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5856 SCENIC AVE
MEXICO NY
13114-3012
US

IV. Provider business mailing address

5856 SCENIC AVE
MEXICO NY
13114-3012
US

V. Phone/Fax

Practice location:
  • Phone: 315-963-4133
  • Fax: 315-963-4960
Mailing address:
  • Phone: 315-963-4133
  • Fax: 315-963-4960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN PATERNITI
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 315-298-6569