Provider Demographics
NPI:1922258615
Name:CATHOLIC CHARITIES OF ONONDAGA COUNTY
Entity type:Organization
Organization Name:CATHOLIC CHARITIES OF ONONDAGA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:AP
Authorized Official - Last Name:MALLOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-362-7536
Mailing Address - Street 1:1654 WEST ONONDAGA STREET
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204
Mailing Address - Country:US
Mailing Address - Phone:315-424-1800
Mailing Address - Fax:
Practice Address - Street 1:1654 W ONONDAGA ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-3310
Practice Address - Country:US
Practice Address - Phone:315-424-1800
Practice Address - Fax:315-424-6045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01996818Medicaid
NY02610373Medicaid