Organization
CHENANGO COUNTY
Active
Other names
PH Prevent
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC DEPPERMAN (ADMIN. SERVICES OFFICER)
(607) 337-1658
Entity
Organization
Contact information
Practice address
5 COURT ST, NORWICH, NY 13815-1695
(607) 337-1660
Mailing address
5 COURT ST, NORWICH, NY 13815-1695
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00474635
—
NY
05
—
03003936
—
NY
Enumeration date
12/29/2006
Last updated
03/24/2016
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