Provider Demographics
NPI:1902045008
Name:SPRINGBROOK NY, INC
Entity Type:Organization
Organization Name:SPRINGBROOK NY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:CARNRIKE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:607-286-7171
Mailing Address - Street 1:2705 STATE HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-3111
Mailing Address - Country:US
Mailing Address - Phone:607-286-7171
Mailing Address - Fax:607-286-7166
Practice Address - Street 1:2705 STATE HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-3111
Practice Address - Country:US
Practice Address - Phone:607-286-7171
Practice Address - Fax:607-286-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency