Organization
GENEVA GENERAL HOSPITAL, INC
Active
Parent organization
GENEVA GENERAL HOSPITAL, INC
Other names
Clyde Family Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENEVA GENERAL HOSPITAL, INC
Authorized official
TRISHA KOCZENT (CFO & TREASURER)
(315) 787-4030
Entity
Organization
Contact information
Practice address
4 W GENESEE ST, CLYDE, NY 14433-1126
(315) 923-3640
Mailing address
4 W GENESEE ST, CLYDE, NY 14433-1126
(315) 923-3640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03029229
—
NY
Enumeration date
03/01/2022
Last updated
03/01/2022
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