Provider Demographics
NPI:1487715975
Name:NORTHEAST COLLEGE OF HEALTH SCIENCES
Entity type:Organization
Organization Name:NORTHEAST COLLEGE OF HEALTH SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-568-3226
Mailing Address - Street 1:2360 STATE ROUTE 89
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-9425
Mailing Address - Country:US
Mailing Address - Phone:315-568-3166
Mailing Address - Fax:315-568-3700
Practice Address - Street 1:2360 STATE ROUTE 89
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148-9425
Practice Address - Country:US
Practice Address - Phone:315-568-3166
Practice Address - Fax:315-568-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56544AMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER