Healthcare Provider Details

I. General information

NPI: 1023147105
Provider Name (Legal Business Name): CHENANGO COUNTY
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

5 COURT ST
NORWICH NY
13815-1695
US

IV. Provider business mailing address

5 COURT ST
NORWICH NY
13815-1695
US

V. Phone/Fax

Practice location:
  • Phone: 607-337-1660
  • Fax: 607-337-1720
Mailing address:
  • Phone: 607-337-1660
  • Fax: 607-337-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCAS W. FLINDT
Title or Position: PUBLIC HEALTH DIRECTOR
Credential:
Phone: 607-337-1660