Provider Demographics
NPI:1407068109
Name:OSWEGO INDUSTRIES INC.
Entity Type:Organization
Organization Name:OSWEGO INDUSTRIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-598-3108
Mailing Address - Street 1:7 MORRILL PL
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-1530
Mailing Address - Country:US
Mailing Address - Phone:315-598-3108
Mailing Address - Fax:315-598-3306
Practice Address - Street 1:7 MORRILL PL
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1530
Practice Address - Country:US
Practice Address - Phone:315-598-3108
Practice Address - Fax:315-598-3306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21790251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02703611Medicaid
NY02004240Medicaid
NY02170836Medicaid
NY01494242Medicaid