Healthcare Provider Details

I. General information

NPI: 1770690737
Provider Name (Legal Business Name): MVHS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 09/02/2025
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HOSPITAL DR
UTICA NY
13502-2517
US

IV. Provider business mailing address

2215 GENESEE ST
UTICA NY
13501-5930
US

V. Phone/Fax

Practice location:
  • Phone: 315-917-9966
  • Fax: 315-234-3998
Mailing address:
  • Phone: 315-801-4238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3202003H
License Number StateNY

VIII. Authorized Official

Name: CODY WHITE
Title or Position: AVP REVENUE CYCLE SERVICES
Credential:
Phone: 315-801-4429