=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205018462
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACCORD CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2007
-----------------------------------------------------
Last Update Date | 11/29/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 84 SCHUYLER ST
-----------------------------------------------------
City | BELMONT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14813-1051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-268-7605
-----------------------------------------------------
Fax | 585-268-7241
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 84 SCHUYLER ST PO BOX 573
-----------------------------------------------------
City | BELMONT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14813-1051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-268-7605
-----------------------------------------------------
Fax | 585-268-7241
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FINANCE DIRECTOR
-----------------------------------------------------
Name | MR. TIM MAHONEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 585-268-7605
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number | 01647185
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------