Provider Demographics
NPI:1831385764
Name:ONEIDA-LEWIS CHAPTER, NYSARC
Entity type:Organization
Organization Name:ONEIDA-LEWIS CHAPTER, NYSARC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT COMPTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:CIFARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-735-6477
Mailing Address - Street 1:245 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-3401
Mailing Address - Country:US
Mailing Address - Phone:315-735-6477
Mailing Address - Fax:
Practice Address - Street 1:245 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-3401
Practice Address - Country:US
Practice Address - Phone:315-735-6477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01585340Medicaid