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NPI Code Detail

MEDICARE: COUNTY OF CHAUTAUQUA - A MUN CORP

MEDICARE: COUNTY OF CHAUTAUQUA - A MUN CORP
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1902897374
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY OF CHAUTAUQUA - A MUN CORP
Provider Business Mailing Address
First Line : 2 ACADEMY ST RM 201
Second Line :
City : MAYVILLE
State : NY
Zip : 14757-1050
Country : US
Telephone Number : 716-753-4104
Fax Number : 716-753-4230
Provider Business Practice Location Address
First Line : 200 E 3RD ST STE 5
Second Line :
City : JAMESTOWN
State : NY
Zip : 14701-5433
Country : US
Telephone Number : 716-661-8330
Fax Number : 716-661-8364
Authorized Official
Title or Position : DIR. OF COMM. MENTAL HYGIENE SER
Name : MR. CARMELO HERNANDEZ
Credential :
Telephone Number : 716-753-4104
Provider Enumeration Date : 11/03/2005
Last Update Date : 06/25/2024

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Directions to “COUNTY OF CHAUTAUQUA - A MUN CORP ” Practice Location

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