Healthcare Provider Details

I. General information

NPI: 1760582142
Provider Name (Legal Business Name): SCHUYLER HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 STEUBEN STREET
MONTOUR FALLS NY
14865
US

IV. Provider business mailing address

220 STEUBEN ST
MONTOUR FALLS NY
14865-9740
US

V. Phone/Fax

Practice location:
  • Phone: 607-535-7154
  • Fax: 607-535-7157
Mailing address:
  • Phone: 607-535-8638
  • Fax: 607-535-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: SUE O'CONNELL
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 607-535-8639