Healthcare Provider Details

I. General information

NPI: 1437471794
Provider Name (Legal Business Name): EMPLOYEE NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 04/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 CLAY AVE
DUNMORE PA
18510-1191
US

IV. Provider business mailing address

1040 VESTAL PKWY E
VESTAL NY
13850-1748
US

V. Phone/Fax

Practice location:
  • Phone: 607-754-1048
  • Fax:
Mailing address:
  • Phone: 607-754-1048
  • Fax: 607-754-1629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. GENE RAYMONDI
Title or Position: CEO
Credential:
Phone: 607-754-1048