Healthcare Provider Details

I. General information

NPI: 1982512166
Provider Name (Legal Business Name): COMPASSIONATE CARE SOLUTIONS OF NY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 NORTH ST
PANAMA NY
14767-9799
US

IV. Provider business mailing address

29 NORTH ST
PANAMA NY
14767-9799
US

V. Phone/Fax

Practice location:
  • Phone: 716-456-1114
  • Fax:
Mailing address:
  • Phone: 716-456-1114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA PECK
Title or Position: OWNER
Credential: SC
Phone: 716-456-1114