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General NPI Number Information
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NPI Number | 1558806034
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Entity Type | Organization
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Legal Business Name | THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF WATERTOWN NY INC.
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Dates
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Enumeration Date | 12/20/2016
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Last Update Date | 12/20/2016
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Provider Practice Location Address
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Address Line | 119 WASHINGTON ST
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City | WATERTOWN
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State | NY
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Zip | 13601-3323
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Country | US
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Telephone | 315-782-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 119 WASHINGTON ST
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City | WATERTOWN
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State | NY
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Zip | 13601-3323
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Country | US
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Telephone | 315-782-3100
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | PETER SCHMITT
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Credential |
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Telephone | 315-782-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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