Provider Demographics
NPI:1710026273
Name:COUNTY OF OTSEGO
Entity Type:Organization
Organization Name:COUNTY OF OTSEGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-547-4230
Mailing Address - Street 1:140 COUNTY HIGHWAY 33W STE 3
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-4955
Mailing Address - Country:US
Mailing Address - Phone:607-547-4230
Mailing Address - Fax:607-547-6402
Practice Address - Street 1:140 COUNTY HIGHWAY 33W
Practice Address - Street 2:SUITE 3
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-4953
Practice Address - Country:US
Practice Address - Phone:607-547-4230
Practice Address - Fax:607-547-4385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1392L001251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02689958Medicaid
NY600001251OtherRR TRAVELERS MEDICARE B
NY54978BMedicare PIN