Provider Demographics
NPI:1154201234
Name:SOTHERN TIER COMMUNITY CARE
Entity type:Organization
Organization Name:SOTHERN TIER COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOTTWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C
Authorized Official - Phone:716-307-1151
Mailing Address - Street 1:6652 S CENTER RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14737-9512
Mailing Address - Country:US
Mailing Address - Phone:716-307-1151
Mailing Address - Fax:716-706-1327
Practice Address - Street 1:6652 S CENTER RD
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NY
Practice Address - Zip Code:14737-9512
Practice Address - Country:US
Practice Address - Phone:716-307-1151
Practice Address - Fax:716-706-1327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty