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General NPI Number Information
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NPI Number | 1386397511
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1 EAST MAIN STREET
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City | MARATHON
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State | NY
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Zip | 13803-3208
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Country | US
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Telephone | 607-849-3900
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Fax | 607-662-4918
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Provider Business Mailing Address
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Address Line | 85 S WEST ST
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City | HOMER
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State | NY
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Zip | 13077-1542
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Country | US
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Telephone | 607-753-3797
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Fax | 607-753-6677
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Authorized Official
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Title or Position | CEO
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Name | KIMBERLY OSBORNE
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Credential |
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Telephone | 607-753-3797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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