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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