Provider Demographics
NPI:1366195067
Name:WY CNTY COMM HOSP
Entity type:Organization
Organization Name:WY CNTY COMM HOSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:ANGELO
Authorized Official - Last Name:CORCIMIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-786-8940
Mailing Address - Street 1:400 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-1025
Mailing Address - Country:US
Mailing Address - Phone:585-786-2233
Mailing Address - Fax:
Practice Address - Street 1:34 DUNCAN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1017
Practice Address - Country:US
Practice Address - Phone:585-786-2290
Practice Address - Fax:585-786-1568
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WY CNTY COMM HOSP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-02
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty