Provider Demographics
NPI:1518962620
Name:COUNTY OF ULSTER NY
Entity Type:Organization
Organization Name:COUNTY OF ULSTER NY
Other - Org Name:UC HEALTH DEPARTMENT LONG TERM HOME HEALTH CARE PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LA MAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HASBROUCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:845-340-3150
Mailing Address - Street 1:300 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-2740
Mailing Address - Country:US
Mailing Address - Phone:845-340-3080
Mailing Address - Fax:845-340-3089
Practice Address - Street 1:300 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2740
Practice Address - Country:US
Practice Address - Phone:845-340-3080
Practice Address - Fax:845-340-3089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5501901L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00901340Medicaid
337022Medicare ID - Type UnspecifiedMEDICARE #