Provider Demographics
NPI:1417292020
Name:NIAGARA COUNTY DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:NIAGARA COUNTY DEPARTMENT OF HEALTH
Other - Org Name:NIAGARA COUNTY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:STAPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:716-439-7435
Mailing Address - Street 1:1001-11TH STREET 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1201
Mailing Address - Country:US
Mailing Address - Phone:716-278-8596
Mailing Address - Fax:716-278-1936
Practice Address - Street 1:1001-TTH STREET
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1201
Practice Address - Country:US
Practice Address - Phone:716-278-8596
Practice Address - Fax:716-278-1936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3101600251K00000X
251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00011196701OtherUNIVERA
NY040401000231OtherFIDELIS
NY8350198OtherINDEPENDENT HEALTH
NY00000052300OtherBLUE CROSS BLUE SHIELD
NY02995908Medicaid
NY03575940Medicaid