Broome Ddso - Clinic

LBN: State Of New York Comptrollers Office
Broome Ddso - Clinic is an health care organization with primary practice located at 28 Hill St Suite 212, Oneonta NY 13820-4696. The organization recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as the primary health care specialty. State Of New York Comptrollers Office can be contacted via phone (607) 432-8860, or through Jefferson, Earl via phone (518) 402-4333.

Contact Information

Primary practice address
28 Hill St Suite 212 Oneonta NY 13820-4696
Phone: (607) 432-8860
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jefferson, Earl
Phone: (518) 402-4333

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X 00233170 New York

Profile Details

NPI number 1134243215
LBN Legal business name State Of New York Comptrollers Office
DBA Doing business as Broome Ddso - Clinic
Authorized official Jefferson, Earl
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 16th, 2007
Last updated Jan 6th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134243215 NPPES
New York MEDICAID 01419121

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