ELDERWOOD AT WAVERLY
NPI 1700242609
Clinic/Center - Adult Day Care in Waverly, NY

Q: What is 37 North Chemung Street Operating Company, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Day Care, with taxonomy code 261QA0600X.

Active since January 07, 2016CLIA 33D1041619 · Waiver

37 N CHEMUNG ST, WAVERLY, NY 14892(607) 565-2861 Get Directions Write a Review

NPPES record last updated: January 19, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Elderwood At Waverly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELDERWOOD AT WAVERLY (NPI 1700242609) is a healthcare organization registered as an adult day care in Waverly, New York and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Jeffrey Rubin, Co- Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1700242609

Entity TypeOrganization

Primary Taxonomy261QA0600X

Legal Business Name37 NORTH CHEMUNG STREET OPERATING COMPANY, LLC

Location Address37 N CHEMUNG STWaverly, NY 14892-1211

Mailing Address500 Seneca St Ste 100Buffalo, NY 14204-1963 · (716) 633-3900

Phone(607) 565-2861

Organization SubpartNo

Authorized OfficialJeffrey RubinCo- Chief Executive Officer · (716) 817-5075

Enumeration DateJanuary 7, 2016

Last NPPES UpdateJanuary 19, 2023

NPPES CertifiedJanuary 19, 2023

✔ NPI 1700242609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Day CareAmbulatory Health Care Facilities

Taxonomy Code261QA0600X

37 N CHEMUNG ST, Waverly, NY 14892

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Other Names 1

Doing Business AsElderwood At Waverly

Other Identifiers 1

Medicaid03006604NY

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1041619

Elderwood At Waverly · Waverly, NY

Active · expires Mar 26, 2027

CLIA Number33D1041619

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateJune 8, 2005

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Joseph C. Mwesige

Laboratory Phone(607) 565-2861

Laboratory LocationElderwood At Waverly37 N Chemung Street, Waverly, NY 14892

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIANE C KOEHLER PTA

Physical Therapy Assistant