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NPI Code Detail

MEDICARE: CHEMUNG COUNTY EARLY INTERVENTION PROGRAM

MEDICARE: CHEMUNG COUNTY EARLY INTERVENTION PROGRAM
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
1252Y00000XEarly Intervention Provider Agency
2251B00000XCase Management Agency

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 : 1457571515
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHEMUNG COUNTY EARLY INTERVENTION PROGRAM
Provider Business Mailing Address
First Line : 425 PENNSYLVANIA AVE
Second Line :
City : ELMIRA
State : NY
Zip : 14904-1762
Country : US
Telephone Number : 607-737-5569
Fax Number : 607-737-5480
Provider Business Practice Location Address
First Line : 425 PENNSYLVANIA AVE
Second Line :
City : ELMIRA
State : NY
Zip : 14904-1762
Country : US
Telephone Number : 607-737-5569
Fax Number : 607-737-5480
Authorized Official
Title or Position : EARLY INTERVENTION OFFICIAL
Name : MRS. ANNE L JERNIGAN
Credential : M.S. CCC-SLP
Telephone Number : 607-737-5568
Provider Enumeration Date : 04/30/2007
Last Update Date : 07/30/2012

Similar Medicare Providers

1346104072 — ALEXIS SCHOONOVER
Practice Location Address:
425 PENNSYLVANIA AVE
ELMIRA, NY
14904-1762
Practice Phone: 607-737-5568
Practice Fax:
1821142878 — CHEMUNG COUNTY DEPT. OF SOCIAL SERVICES
Practice Location Address:
425 PENNSYLVANIA AVE
ELMIRA, NY
14904-1762
Practice Phone: 607-737-2979
Practice Fax: 607-737-5359
1053531202 — CHEMUNG COUNTY EARLY INTERVENTION PROGRAM
Practice Location Address:
425 PENNSYLVANIA AVE
ELMIRA, NY
14904-1762
Practice Phone: 607-737-5569
Practice Fax: 607-737-5480
1679883961 — THOMAS R MITCHELL MD PC
Practice Location Address:
425 PENNSYLVANIA AVE
ELMIRA, NY
14904-1762
Practice Phone: 607-732-1310
Practice Fax: 307-733-0940
1386906097 — KELLY M SIDARI
Practice Location Address:
425 PENNSYLVANIA AVE
ELMIRA, NY
14904-1762
Practice Phone: 607-737-5565
Practice Fax: 607-737-2980
1336401827 — MARLENE REYNOLDS M.S.ED
Practice Location Address:
425 PENNSYLVANIA AVE
ELMIRA, NY
14904-1762
Practice Phone: 607-737-5566
Practice Fax: 607-737-5480

Directions to “CHEMUNG COUNTY EARLY INTERVENTION PROGRAM ” Practice Location

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