Provider Demographics
NPI:1871640805
Name:TOWN OF CATSKILL OFFICE OF SUPERVISOR
Entity Type:Organization
Organization Name:TOWN OF CATSKILL OFFICE OF SUPERVISOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWN SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:PARSLEY
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-943-2141
Mailing Address - Street 1:439 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-1317
Mailing Address - Country:US
Mailing Address - Phone:518-943-0549
Mailing Address - Fax:518-943-0209
Practice Address - Street 1:439 MAIN ST
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414
Practice Address - Country:US
Practice Address - Phone:518-943-0549
Practice Address - Fax:518-943-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06463416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02353744Medicaid
NY10060192OtherCDPHP
NYA50331Medicare ID - Type UnspecifiedEMPIRE MEDICARE
NY02353744Medicaid