Healthcare Provider Details

I. General information

NPI: 1821177528
Provider Name (Legal Business Name): WYOMING COUNTY EARLY INTERVENTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PERRY AVE
WARSAW NY
14569-1220
US

IV. Provider business mailing address

8 PERRY AVE
WARSAW NY
14569-1220
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-8850
  • Fax: 585-786-8852
Mailing address:
  • Phone: 585-786-8850
  • Fax: 585-786-8852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEE SCHWAB
Title or Position: FISCAL OFFICER
Credential:
Phone: 585-786-8850