MEDICARE: THE CHAUTAUQUA CENTER, 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
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

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

General Provider Information

NPI Number	:	1760747521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CHAUTAUQUA CENTER, INC

Provider Business Mailing Address
First Line	:	75 E 3RD ST
Second Line	:
City	:	DUNKIRK
State	:	NY
Zip	:	14048-2239
Country	:	US
Telephone Number	:	716-363-6050
Fax Number	:	716-363-6333

Provider Business Practice Location Address
First Line	:	75 E 3RD ST
Second Line	:
City	:	DUNKIRK
State	:	NY
Zip	:	14048
Country	:	US
Telephone Number	:	716-363-6050
Fax Number	:	716-363-6333

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. MICHAEL C PEASE
Credential	:
Telephone Number	:	716-363-6050

Provider Enumeration Date	:	07/09/2012
Last Update Date	:	06/23/2026

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