Basic Information
| Provider Information | |||||||||
| NPI: | 1093975583 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BROOME COUNTY HEALTH DEPARTMENT-LHCSA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 FRONT ST. | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139052424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077782802 | ||||||||
| FaxNumber: | 6077782864 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 FRONT ST. | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139052424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077782802 | ||||||||
| FaxNumber: | 6077782864 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2008 | ||||||||
| LastUpdateDate: | 04/21/2011 | ||||||||
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| AuthorizedOfficialLastName: | EDWARDS | ||||||||
| AuthorizedOfficialFirstName: | CLAUDIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PUBLIC HEALTH DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6077782802 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MS BS | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 0938L001 | NY | Y | Agencies | Home Health |
No ID Information.