Provider Demographics
NPI:1508006800
Name:FRANKLIN-ESSEX-HAMILTON BOCES
Entity Type:Organization
Organization Name:FRANKLIN-ESSEX-HAMILTON BOCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:O'DELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-483-6420
Mailing Address - Street 1:23 HUSKIE LN
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-2450
Mailing Address - Country:US
Mailing Address - Phone:518-483-6420
Mailing Address - Fax:518-483-2178
Practice Address - Street 1:23 HUSKIE LN
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-2450
Practice Address - Country:US
Practice Address - Phone:518-483-6420
Practice Address - Fax:518-483-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008146-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03566667Medicaid