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Organization

SENIOR NETWORK HEALTH, LLC

Active
Parent organization
MOHAWK VALLEY NETWORK
Organization subpart
Yes

Provider details

NPI number
Legal business name
MOHAWK VALLEY NETWORK
Authorized official
MRS. ANDREA LAZAREK-LAQUAY (DIRECTOR/CHIEF OPERATING OFFICER)
(315) 624-4555
Entity
Organization

Contact information

Practice address
2521 SUNSET AVE, UTICA, NY 13502-5825
(315) 624-4565
(315) 624-4541
Mailing address
2521 SUNSET AVE, UTICA, NY 13502-5825
(315) 624-4565
(315) 624-4541

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
01778523
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01778523
NY
Enumeration date
06/26/2008
Last updated
06/26/2008
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  • EDI platform