Healthcare Provider Details

I. General information

NPI: 1457473514
Provider Name (Legal Business Name): COUNTY OF CATTARAUGUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/03/2012
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 Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0401200R
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNY

VIII. Authorized Official

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