NPIMap

Organization Active NPI

Vestal Healthcare, LLC

Doing business as Freedom Center of Binghamton

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Binghamton, NY
National Provider Identifier
1477918597
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
VESTAL HEALTHCARE, LLC
Doing business as
Freedom Center of Binghamton
Practice address
65 Pennsylvania Ave
Binghamton, NY 13903-1651
Phone
(607) 772-0419
Fax
(607) 772-0457
NPI assigned
Dec 16, 2015
Last updated
Jan 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Caputo
Title
President
Phone
(781) 699-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

65 Pennsylvania Ave
Binghamton, NY 13903-1651

Mailing address

65 Pennsylvania Ave
Binghamton, NY 13903-1651
Phone (607) 772-0419

Other names 1

  • Freedom Center of Binghamton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1477918597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PENNSYLVANIA AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139031651",
            "telephone_number": "607-772-0419",
            "fax_number": "607-772-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PENNSYLVANIA AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139031651",
            "telephone_number": "607-772-0419",
            "fax_number": "607-772-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTAL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-16",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "CAPUTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Center of Binghamton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.