Provider Demographics
NPI:1144360090
Name:SCHDY CNTY PUBLIC HEALTH SVCS- CPSE
Entity type:Organization
Organization Name:SCHDY CNTY PUBLIC HEALTH SVCS- CPSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY COMMISSIONER- SCPHS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CALLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-386-2810
Mailing Address - Street 1:107 NOTT TER
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3170
Mailing Address - Country:US
Mailing Address - Phone:518-386-2815
Mailing Address - Fax:518-386-2801
Practice Address - Street 1:107 NOTT TER
Practice Address - Street 2:SUITE 306
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3170
Practice Address - Country:US
Practice Address - Phone:518-386-2815
Practice Address - Fax:518-386-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01430928Medicaid