Healthcare Provider Details

I. General information

NPI: 1255460390
Provider Name (Legal Business Name): NIAGARA COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 11TH ST TROTT ACCESS CENTER
NIAGARA FALLS NY
14301-1201
US

IV. Provider business mailing address

1001 11TH ST TROTT ACCESS CENTER
NIAGARA FALLS NY
14301-1201
US

V. Phone/Fax

Practice location:
  • Phone: 716-278-1991
  • Fax: 716-278-8288
Mailing address:
  • Phone: 716-278-1991
  • Fax: 716-278-8288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LISA M CHESTER
Title or Position: DIRECTOR/CHILDREN W/ SPECIAL NEEDS
Credential: M.P.A
Phone: 716-278-1991