Provider Demographics
NPI:1134340243
Name:TOWN OF PLATTSBURGH MORRISONVILLE
Entity type:Organization
Organization Name:TOWN OF PLATTSBURGH MORRISONVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-562-7047
Mailing Address - Street 1:PO BOX 2846
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-0258
Mailing Address - Country:US
Mailing Address - Phone:518-562-7900
Mailing Address - Fax:518-562-7933
Practice Address - Street 1:21 BANKER ROAD
Practice Address - Street 2:
Practice Address - City:MORRISONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12962-3730
Practice Address - Country:US
Practice Address - Phone:518-562-7900
Practice Address - Fax:518-562-7933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3652341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA04681OtherEMPIRE
NY954168OtherMVP
NY01767422Medicaid
NY000401716001OtherBSNENY
NY=========OtherAETNA
NYA04681OtherEMPIRE
NY=========OtherEXCELLUS
NY01767422Medicaid
NY=========OtherUHC
NY=========OtherCIGNA
NY55984BMedicare ID - Type Unspecified