Provider Demographics
NPI:1922184043
Name:YATES COUNTY PUBLIC HEALTH
Entity Type:Organization
Organization Name:YATES COUNTY PUBLIC HEALTH
Other - Org Name:YATES COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:315-536-5160
Mailing Address - Street 1:417 LIBERTY ST
Mailing Address - Street 2:STE. 2120
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-1100
Mailing Address - Country:US
Mailing Address - Phone:315-536-5160
Mailing Address - Fax:315-536-5146
Practice Address - Street 1:417 LIBERTY ST
Practice Address - Street 2:STE. 2120
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1100
Practice Address - Country:US
Practice Address - Phone:315-536-5160
Practice Address - Fax:315-536-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03002022Medicaid