| Wic Program | |
|
117 E Steuben St Bath NY 14810-1636 | |
| (607) 776-1151 | |
| (607) 776-2803 |
| Full Name | Wic Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 117 E Steuben St, Bath, New York |
| Authorized Official Name and Position | Lisa Cogswell (WIC PROGRAM DIRECTOR) |
| Authorized Official Contact | 6077761151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wic Program 117 E Steuben St Bath NY 14810-1636 Ph: (607) 776-1151 | Wic Program 117 E Steuben St Bath NY 14810-1636 Ph: (607) 776-1151 |
| NPI Number | 1639404064 |
|---|---|
| Provider Enumeration Date | 10/02/2009 |
| Last Update Date | 10/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639404064 | NPI | - | NPPES |
| 01168258 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | NO TAXONOMY CODE (New York) | Primary |
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