Provider Demographics
NPI:1255703138
Name:ELMIRA PSYCHIATRIC CENTER
Entity type:Organization
Organization Name:ELMIRA PSYCHIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. DIRECTOR OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DREHMER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:607-737-4733
Mailing Address - Street 1:54 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-3036
Mailing Address - Country:US
Mailing Address - Phone:607-731-2372
Mailing Address - Fax:
Practice Address - Street 1:100 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2849
Practice Address - Country:US
Practice Address - Phone:607-737-4733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY632098273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit