Provider Demographics
NPI:1336635010
Name:UCPA OF NIAGARA COUNTY, INC.
Entity type:Organization
Organization Name:UCPA OF NIAGARA COUNTY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUDGET MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MANGUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-297-0798
Mailing Address - Street 1:9812 LOCKPORT RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-1197
Mailing Address - Country:US
Mailing Address - Phone:716-297-0798
Mailing Address - Fax:716-297-0998
Practice Address - Street 1:9812 LOCKPORT RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-1197
Practice Address - Country:US
Practice Address - Phone:716-297-0798
Practice Address - Fax:716-297-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02731946Medicaid
NY1073667176Medicaid
NY1669526745Medicaid
NY1871647974Medicaid
NY02252757Medicaid
NY1124459383Medicaid
NY1780738880Medicaid
NY02005347Medicaid
NY02703419Medicaid
NY1083048912Medicaid
NY1922246420Medicaid
NY01387186Medicaid