Basic Information
Provider Information
NPI: 1538640792
EntityType: 2
ReplacementNPI:  
OrganizationName: LITTLE FALLS HOSPITAL
LastName:  
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Mailing Information
Address1: 140 BURWELL STREET
Address2:  
City: LITTLE FALLS
State: NY
PostalCode: 13365
CountryCode: US
TelephoneNumber: 3158235281
FaxNumber: 3158235383
Practice Location
Address1: 3085 BRIDGE STREET
Address2:  
City: NEWPORT
State: NY
PostalCode: 134160408
CountryCode: US
TelephoneNumber: 3158456100
FaxNumber: 3158456035
Other Information
ProviderEnumerationDate: 08/27/2018
LastUpdateDate: 08/27/2018
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: VIELKIND
AuthorizedOfficialFirstName: JAMES
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 3158235281
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR1300X2129700CNYY Ambulatory Health Care FacilitiesClinic/CenterRural Health

No ID Information.


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