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General NPI Number Information
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NPI Number | 1699130450
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Entity Type | Organization
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Legal Business Name | BROOME COUNTY
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 413 OLD MILL RD
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City | VESTAL
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State | NY
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Zip | 13850-3520
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Country | US
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Telephone | 607-763-4464
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Fax | 607-763-4468
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Provider Business Mailing Address
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Address Line | 413 OLD MILL RD
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City | VESTAL
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State | NY
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Zip | 13850-3520
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Country | US
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Telephone | 607-763-4464
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Fax | 607-763-4468
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Authorized Official
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Title or Position | COMMISSIONER
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Name | GREGORY KILMER
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Credential |
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Telephone | 607-763-4469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number |
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License Number State | NY
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