Healthcare Provider Details

I. General information

NPI: 1477639599
Provider Name (Legal Business Name): YATES COUNTY PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 LIBERTY ST STE. 2120
PENN YAN NY
14527-1100
US

IV. Provider business mailing address

417 LIBERTY ST STE. 2120
PENN YAN NY
14527-1100
US

V. Phone/Fax

Practice location:
  • Phone: 315-536-5160
  • Fax: 315-536-5145
Mailing address:
  • Phone: 315-536-5160
  • Fax: 315-536-5145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNY

VIII. Authorized Official

Name: MRS. DEBORAH A MINOR
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: RN
Phone: 315-536-5160