Healthcare Provider Details

I. General information

NPI: 1801719539
Provider Name (Legal Business Name): NORTHERN OSWEGO COUNTY HEALTH SERVICES, INC. DBA CONNEXTCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 DELANO ST
PULASKI NY
13142-1400
US

IV. Provider business mailing address

61 DELANO ST
PULASKI NY
13142-1400
US

V. Phone/Fax

Practice location:
  • Phone: 315-298-6569
  • Fax: 315-298-7488
Mailing address:
  • Phone: 315-298-6569
  • Fax: 315-298-7488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: TRICIA ANN PETER CLARK
Title or Position: PRESIDENT CEO
Credential:
Phone: 315-298-6569