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Organization

FAXTON ST LUKES HEALTHCARE

Active
Parent organization
FAXTON ST LUKES HEALTHCARE
Organization subpart
Yes

Provider details

NPI number
Legal business name
FAXTON ST LUKES HEALTHCARE
Authorized official
CODY WHITE (EXECUTIVE DIRECTOR)
(315) 801-4429
Entity
Organization

Contact information

Practice address
1650 CHAMPLIN AVE, UTICA, NY 13502
(315) 624-5145
(315) 624-6113
Mailing address
2209 GENESEE ST/ BUSINESS OFFICE, ROOM #315, UTICA, NY 13501-5809
(315) 018-3282

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
3203003H
NY

Other

Enumeration date
04/11/2013
Last updated
07/12/2023
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