Healthcare Provider Details

I. General information

NPI: 1235494733
Provider Name (Legal Business Name): CATTARAUGUS COUNTY DEPT. OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LEO MOSS DR SUITE 4010
OLEAN NY
14760-1100
US

IV. Provider business mailing address

1 LEO MOSS DR SUITE 4010
OLEAN NY
14760-1100
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-8050
  • Fax: 716-701-3737
Mailing address:
  • Phone: 716-373-8050
  • Fax: 716-701-3737

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: DR. KEVIN D WATKINS
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: M.D., MPH
Phone: 716-373-8050