Provider Demographics
NPI:1225226962
Name:TRI TOWN REGIONAL HEALTHCARE
Entity Type:Organization
Organization Name:TRI TOWN REGIONAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-563-7080
Mailing Address - Street 1:43 PEARL ST WEST
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NY
Mailing Address - Zip Code:13838-1330
Mailing Address - Country:US
Mailing Address - Phone:607-563-7080
Mailing Address - Fax:
Practice Address - Street 1:43 PEARL ST WEST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838-1330
Practice Address - Country:US
Practice Address - Phone:607-561-2021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherEIN
NY330408Medicare Oscar/Certification