| NAME |
KINGSTON CBOC |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
101 FRANK SOTTILE BLVD |
| CITY |
KINGSTON |
| ZIP |
12401-1540 |
| OFFICIAL VA NAME |
KINGSTON CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
KINGSTON VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1952339400
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
528GZ |
| HISTORY |
-
- EFFECTIVE DATE: 2000-07-01 00:00:00
- REALIGNED FROM: ZZ KINGSTON
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1952339400
-
- CODING SYSTEM: VASTANUM
- ID: 528GZ
-
- CODING SYSTEM: CLIA
- ID: 33D2077349
|
