| Organization Name: | FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC |
| NPI Number: | 1114158276 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WALTER PRIEST (EXECUTIVE DIRECTOR) |
| Mailing Address: | 22-24 East Main Street Marathon |
| State: | NY US |
| Postal Code: | 138030448 |
| Phone Number: | 6078493271 |
| Fax Number: | 6078496357 |
| NPI Enumeration Date: | 08/06/2009 |
| NPI Last Update Date: | 12/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |