Provider Demographics
NPI:1144358995
Name:PUTNAM COUNTY HEALTH DEPARTMENT NURSING SERVICES
Entity type:Organization
Organization Name:PUTNAM COUNTY HEALTH DEPARTMENT NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMISSIONER OF HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:NESHEIWAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS, FAAP
Authorized Official - Phone:845-278-6130
Mailing Address - Street 1:1 GENEVA RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-2339
Mailing Address - Country:US
Mailing Address - Phone:845-278-6558
Mailing Address - Fax:845-278-7921
Practice Address - Street 1:1 GENEVA RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-2339
Practice Address - Country:US
Practice Address - Phone:845-278-6558
Practice Address - Fax:845-278-7921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00321908Medicaid
NY337161Medicare ID - Type UnspecifiedCHHA