Provider Demographics
NPI:1386536209
Name:BINGHAMTON PROJECT, LLC
Entity type:Organization
Organization Name:BINGHAMTON PROJECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENQUEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-833-2375
Mailing Address - Street 1:440 WEST COMMONS WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790
Mailing Address - Country:US
Mailing Address - Phone:860-833-2375
Mailing Address - Fax:
Practice Address - Street 1:440 WEST COMMONS WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790
Practice Address - Country:US
Practice Address - Phone:860-833-2375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK HOLDCO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical