# GENEVA GENERAL HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GENEVA GENERAL HOSPITAL, INC
- **Other names:** Clyde Family Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255087003
- **Legal business name:** GENEVA GENERAL HOSPITAL, INC
- **Authorized official:** TRISHA KOCZENT (CFO & TREASURER)
- **Authorized official phone:** (315) 787-4030

## Contact information

- **Practice address:** 4 W GENESEE ST, CLYDE, NY 14433-1126
- **Practice address phone:** (315) 923-3640
- **Mailing address:** 4 W GENESEE ST, CLYDE, NY 14433-1126
- **Mailing address phone:** (315) 923-3640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/01/2022
- **Last updated:** 03/01/2022