Pathfinder Village, Inc

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

License

0493493 Issued in NY

Legal business name

PATHFINDER VILLAGE, INC

Practice address

3 Chenango Road
Edmeston, NY 13335

Phone

(607) 965-8377

Fax

(607) 965-8655

NPI assigned

Sep 18, 2007

Last updated

Sep 18, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edward A Shafer

Title

Ceo

Phone

(607) 965-8377

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maureen Elizabeth Davidson, OTR/L

  • Occupational Therapist
  • Edmeston, NY
  • NPI 1013725225
  NPD (past)
• Emily Hamilton

  • Occupational Therapist
  • Edmeston, NY
  • NPI 1174946255
  NPD (past)
• Lee Whelihan

  • Speech-Language Pathologist
  • Edmeston, NY
  • NPI 1265189690
  NPD (past)

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1821284480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CHENANGO ROAD",
            "city": "EDMESTON",
            "state": "NY",
            "postal_code": "13335",
            "telephone_number": "607-965-8377",
            "fax_number": "607-965-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CHENANGO ROAD",
            "city": "EDMESTON",
            "state": "NY",
            "postal_code": "13335",
            "telephone_number": "607-965-8377",
            "fax_number": "607-965-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHFINDER VILLAGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "607-965-8377"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NY",
            "license": "0493493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02248346",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02004548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Hamilton
• Mary Imogene Bassett Hospital
• Gayle A. Morley, LCSW-R
• Donna Sue Mumbulo, LPN
• Alexis Corine Nejati
• Courtney Polimeni
• Amy Rifanburg
• Brittney Rowlands, OTR/L
• Christina Rutenber
• Mary Christine Stanton

• Voluntary or Charitable Agency in Edmeston, NY
• Providers in Edmeston, NY by specialty
• Voluntary or Charitable Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.