Healthcare Provider Details

I. General information

NPI: 1134148570
Provider Name (Legal Business Name): COUNTY OF CATTARAUGUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 02/12/2010
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: 716-701-3382
  • 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 Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0401200R
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00030716901
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerUNIVERA - FP
# 2
Identifier000560763001
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerBC/BS - GRACZYK
# 3
Identifier8390018
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerIH - CLINIC
# 4
Identifier9512666
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerIH- MCANDREW
# 5
Identifier9512632
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerIH - GRACZYK
# 6
Identifier00474777
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 7
Identifier00011208901
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerUNIVERA - CLINIC
# 8
Identifier000512768001
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerBC/BS - CLINIC
# 9
Identifier000560783001
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerBC/BS - MCANDREW

VIII. Authorized Official

Name: DR. KEVIN D WATKINS
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: MD, MPH
Phone: 716-701-3398