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Organization
WYOMING COUNTY
Active
Organization
WYOMING COUNTY
Active
Parent organization
WYOMING COUNTY
Organization subpart
Yes
Provider details
NPI number
Legal business name
WYOMING COUNTY
Authorized official
MR. MICHAEL A. CORCIMIGLIA (COO)
(585) 786-8940
Entity
Organization
Contact information
Practice address
400 N MAIN ST, WARSAW, NY 14569-1025
(585) 786-8940
(585) 786-1222
Mailing address
143 N MAIN ST, WARSAW, NY 14569-1100
(585) 786-8940
(585) 786-1222
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Y00000X
Otolaryngology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00040514704
UNIVERA
NY
01
—
000525907002
BLUE CROSS
NY
05
—
03372245
—
NY
05
—
70102A
—
NY
01
—
FA0944
PREFERRED CARE
NY
Enumeration date
05/09/2007
Last updated
05/05/2015
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