Provider Demographics
NPI:1336454586
Name:MADISON CORTLAND CHAPTER, NYSARC, INC
Entity type:Organization
Organization Name:MADISON CORTLAND CHAPTER, NYSARC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-363-3389
Mailing Address - Street 1:701 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-1500
Mailing Address - Country:US
Mailing Address - Phone:315-363-3389
Mailing Address - Fax:315-363-4286
Practice Address - Street 1:701 LENOX AVE
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-1500
Practice Address - Country:US
Practice Address - Phone:315-363-3389
Practice Address - Fax:315-363-4286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency