Provider Demographics
NPI:1760582142
Name:SCHUYLER HOSPITAL INC
Entity Type:Organization
Organization Name:SCHUYLER HOSPITAL INC
Other - Org Name:SCHUYLER HOSPITAL PHYSICIAN GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-535-8639
Mailing Address - Street 1:220 STEUBEN ST
Mailing Address - Street 2:
Mailing Address - City:MONTOUR FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14865-9740
Mailing Address - Country:US
Mailing Address - Phone:607-535-8638
Mailing Address - Fax:607-535-4433
Practice Address - Street 1:230 STEUBEN STREET
Practice Address - Street 2:
Practice Address - City:MONTOUR FALLS
Practice Address - State:NY
Practice Address - Zip Code:14865
Practice Address - Country:US
Practice Address - Phone:607-535-7154
Practice Address - Fax:607-535-7157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207Q00000X, 207R00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000012654OtherBCBS
NY70055AMedicare ID - Type Unspecified