Provider Demographics
NPI:1932281706
Name:COUNTY OF GREENE
Entity Type:Organization
Organization Name:COUNTY OF GREENE
Other - Org Name:GREENE COUNTY FAMILY PLANNING
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF PUBLIC HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHURCHILL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:518-719-3630
Mailing Address - Street 1:411 MAIN STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414
Mailing Address - Country:US
Mailing Address - Phone:518-672-4533
Mailing Address - Fax:
Practice Address - Street 1:411 MAIN STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414
Practice Address - Country:US
Practice Address - Phone:518-719-3580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENE COUNTY PUBLIC HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-20
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304379251K00000X
NY261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473125Medicaid