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General NPI Number Information
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NPI Number | 1093258873
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Entity Type | Organization
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Legal Business Name | NEWARK-WAYNE COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 1200 DRIVING PARK AVE
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City | NEWARK
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State | NY
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Zip | 14513-1090
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Country | US
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Telephone | 585-426-1234
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Fax | 585-247-2797
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Provider Business Mailing Address
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Address Line | 1200 DRIVING PARK AVE
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City | NEWARK
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State | NY
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Zip | 14513-1090
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Country | US
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Telephone | 585-426-1234
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Fax | 585-247-2797
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Authorized Official
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Title or Position | CFO
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Name | THOMAS CRILLY
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Credential |
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Telephone | 585-922-5497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 33D0654949
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License Number State | NY
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