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NPI Code Detail

MEDICARE: HERKIMER COUNTY CHAPTER NYSARC, INC.

MEDICARE: HERKIMER COUNTY CHAPTER NYSARC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD1600XDevelopmental Disabilities Clinic/CenterNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093841462
Entity Type Code : Organization
Provider Name (Legal Business Name) : HERKIMER COUNTY CHAPTER NYSARC, INC.
Provider Business Mailing Address
First Line : 350 S WASHINGTON ST
Second Line :
City : HERKIMER
State : NY
Zip : 13350-2426
Country : US
Telephone Number : 315-866-2920
Fax Number : 315-866-8339
Provider Business Practice Location Address
First Line : 350 S WASHINGTON ST
Second Line :
City : HERKIMER
State : NY
Zip : 13350-2426
Country : US
Telephone Number : 315-866-2920
Fax Number : 315-866-8339
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. KEVIN CROSLEY
Credential :
Telephone Number : 315-866-2920
Provider Enumeration Date : 02/27/2007
Last Update Date : 08/22/2020

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1487653853 — HERKIMER COUNTY
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Directions to “HERKIMER COUNTY CHAPTER NYSARC, INC. ” Practice Location

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