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Organization
MERCY HOSPITAL OF WATERTOWN UNITED STATES CATHOLIC CONFERENCE
Active
Organization
MERCY HOSPITAL OF WATERTOWN UNITED STATES CATHOLIC CONFERENCE
Active
Other names
Genesis Healthcare of New York
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI L BRAY R.N. (DPS/ADMINISTRATOR)
(315) 782-0415
Entity
Organization
Contact information
Practice address
199 PRATT ST, WATERTOWN, NY 13601-4349
(315) 782-0415
(315) 786-0417
Mailing address
199 PRATT ST, WATERTOWN, NY 13601-4349
(315) 782-0415
(315) 786-0417
Taxonomy
Speciality
Code
Description
License number
State
2472R0900X
Renal Dialysis Technician
—
—
251E00000X
Home Health Agency
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01226553
—
NY
01
—
113538582
COMM
—
01
—
337254
TRICARE
—
01
—
344246
GHI VALUE OPTIONS
NY
01
—
C52892A
1ST UNITED AMERICAN
NY
01
—
P014001500
BC ROCHESTER
—
Enumeration date
01/05/2006
Last updated
10/02/2013
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