Healthcare Provider Details

I. General information

NPI: 1972101491
Provider Name (Legal Business Name): SOLDIERS & SAILORS MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

367 E MAIN ST
WATERLOO NY
13165-1662
US

IV. Provider business mailing address

418 N MAIN ST
PENN YAN NY
14527-1070
US

V. Phone/Fax

Practice location:
  • Phone: 315-787-4977
  • Fax:
Mailing address:
  • Phone: 315-531-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY H MORGAN
Title or Position: CFO & TREASURER
Credential:
Phone: 315-787-4030