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General NPI Number Information
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NPI Number | 1528119666
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Entity Type | Organization
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Legal Business Name | TIOGA COUNTY HEALTH DEPARTMENT
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 1062 RTE 38
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City | OWEGO
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State | NY
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Zip | 13827-3209
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Country | US
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Telephone | 607-687-8600
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Fax | 607-687-2916
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Provider Business Mailing Address
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Address Line | 1062 RTE 38
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City | OWEGO
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State | NY
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Zip | 13827-3209
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Country | US
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Telephone | 607-687-8600
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Fax | 607-687-2916
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Authorized Official
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Title or Position | ADMINISTRATIVE ACCOUNTING SUPERVISO
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Name | MS. JANICE MARIE YURICEK
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Credential |
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Telephone | 607-687-8573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 5324200R
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License Number State | NY
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