Provider Demographics
NPI:1942480736
Name:PARTNERSHIP IN HEALTH C
Entity Type:Organization
Organization Name:PARTNERSHIP IN HEALTH C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADENHAUSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-389-5181
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:NY
Mailing Address - Zip Code:13697-0208
Mailing Address - Country:US
Mailing Address - Phone:315-389-5181
Mailing Address - Fax:315-389-5183
Practice Address - Street 1:652 STATE HIGHWAY 11C
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:NY
Practice Address - Zip Code:13697-3244
Practice Address - Country:US
Practice Address - Phone:315-389-5181
Practice Address - Fax:315-389-5183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00654971Medicaid
NYW53164Medicare UPIN
NY53046AMedicare PIN