Provider Demographics
NPI:1457680969
Name:ERIE COUNTY DEPARTMENT OF SENIOR SERVICES
Entity Type:Organization
Organization Name:ERIE COUNTY DEPARTMENT OF SENIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMISSIONER, ERIE COUNTY SR. SVCS.
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:W
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-858-6046
Mailing Address - Street 1:95 FRANKLIN ST RM 1329
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-3968
Mailing Address - Country:US
Mailing Address - Phone:716-858-6046
Mailing Address - Fax:716-858-7259
Practice Address - Street 1:95 FRANKLIN ST RM 1329
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-3968
Practice Address - Country:US
Practice Address - Phone:716-858-6046
Practice Address - Fax:716-858-7259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000585191001OtherPROVIDER NUMBER