Provider Demographics
NPI:1871631689
Name:SCHENECTADY COUNTY
Entity Type:Organization
Organization Name:SCHENECTADY COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMBASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-384-3622
Mailing Address - Street 1:59 HETCHELTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:NY
Mailing Address - Zip Code:12302-5506
Mailing Address - Country:US
Mailing Address - Phone:518-384-3613
Mailing Address - Fax:518-384-1624
Practice Address - Street 1:59 HETCHELTOWN RD
Practice Address - Street 2:
Practice Address - City:SCOTIA
Practice Address - State:NY
Practice Address - Zip Code:12302-5506
Practice Address - Country:US
Practice Address - Phone:518-384-3613
Practice Address - Fax:518-384-1624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4651300N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473863Medicaid
NY00473863Medicaid
NY335252Medicare Oscar/Certification