Provider Demographics
NPI:1134104573
Name:VISITING NURSE ASSOCIATION OF UTICA AND ONEIDA COUNTY INC
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF UTICA AND ONEIDA COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BPS LNHA
Authorized Official - Phone:315-624-8900
Mailing Address - Street 1:1650 CHAMPLIN AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4801
Mailing Address - Country:US
Mailing Address - Phone:315-624-8900
Mailing Address - Fax:315-735-6027
Practice Address - Street 1:1650 CHAMPLIN AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4801
Practice Address - Country:US
Practice Address - Phone:315-624-8900
Practice Address - Fax:315-735-6027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-08
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3202602251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00474277Medicaid
NY337078Medicare Oscar/Certification