Provider Demographics
NPI:1902973613
Name:STAFKINGS HEALTHCARE SYSTEMS, INC.
Entity Type:Organization
Organization Name:STAFKINGS HEALTHCARE SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-772-8080
Mailing Address - Street 1:66 HAWLEY ST
Mailing Address - Street 2:PO BOX 1015
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-3833
Mailing Address - Country:US
Mailing Address - Phone:607-772-8080
Mailing Address - Fax:607-772-0218
Practice Address - Street 1:66 HAWLEY ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-3833
Practice Address - Country:US
Practice Address - Phone:607-772-8080
Practice Address - Fax:607-772-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00975755Medicaid
NY01052437Medicaid
NY02393286Medicaid