The east–west highway between the town of Horseheads and the village of Candor by way of the villages of Van Etten and Spencer was originally designated as NY 53 in the mid-1920s. NY 53 was renumbered to NY 223 as part of the 1930 renumbering of state highways in New York.
The east-west highway between Horseheads and Candor, passing through Van Etten and Spencer, was initially designated as NY 53 in the mid-1920s.  This designation was changed to NY 223 during a state-wide highway renumbering project in 1930.