| Document Date: 2014-03-18 17:22:23
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City NYC / New York City / / Company Immunization Schedule Lead References / / / Event Product Issues / Product Recall / / Facility Facility Code / Facility Name / / / IndustryTerm Online Registry / ONLINE REGISTRY ACCEPTABLE USE / Online Registry Access / online documents / state law / attached Online Registry Quickguide / job site / Online Registry QuickGuide Phone / attached Online Registry Access forms / Online Access / search combinations / Online Registry Please / Online Registry button / Online Registry account set-up instructions / Online Registry Security / / MedicalTreatment immunization / immunizations / / Organization NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE Mary T. Bassett / Department of Health / / Person Designation / Designee / Mary T. Bassett / / / Position attached Site Security Administrator / OFFICIAL / supervising physician / physician / Governor / Director / CEO / person authorizing Security Administrator / supervising physician / physician assistant / Designated Security Administrator / director / supervising physician / Security Administrator / Site Security Administrator / Mental Hygiene Online Registry Security Administrator / Commissioner / nurse / DOHMH Security Administrator / physician assistant / or nurse practitioner / Mental Hygiene Immunization Registry Security Administrator / assistant / User Manager / License Number_______________________ Supervising Physician / / Product Schedule Lead References / / ProvinceOrState Oregon / / Technology attached protocol / / URL www.nyc.gov/health/cir / http /
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NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE Mary T. Bassett, M.D., M.P.H., Commissioner