Provider Demographics
NPI:1871882183
Name:GREATER BINGHAMTON HEALTH CENTER
Entity type:Organization
Organization Name:GREATER BINGHAMTON HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:GAY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:607-773-4223
Mailing Address - Street 1:3 ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13904-1307
Mailing Address - Country:US
Mailing Address - Phone:607-722-2160
Mailing Address - Fax:
Practice Address - Street 1:425 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13904-1735
Practice Address - Country:US
Practice Address - Phone:607-773-4223
Practice Address - Fax:607-773-4476
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OFFICE MENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital