National Provider Identifier
State Of New York
State Of New York is listed in the NPPES registry with a primary specialty of Intellectual Disabilities Intermediate Care Facility in Rochester, NY and a listed phone number of (518) 402-4333.
Profile Overview
- NPI
- 1639218456
- Provider Type
- Organization
- Primary Specialty
- Intellectual Disabilities Intermediate Care Facility
- Enumeration Date
- February 06, 2007
- Last Updated
- June 27, 2008
Practice Location
- 620 Westfall RD
- Rochester, NY 14620-4610
Phone: (518) 402-4333
Mailing Address
- 44 Holland Ave
- Albany, NY 12229-0001
Specialties
- Intellectual Disabilities Intermediate Care Facility (315P00000X)
Full Record
- NPI
- 1639218456
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- State Of New York
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 44 Holland Ave
- Mailing City
- Albany
- Mailing State
- NY
- Mailing ZIP Code
- 12229-0001
- Mailing Country
- US
- Mailing Phone
- (518) 402-4333
- Practice Street Address
- 620 Westfall RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-4610
- Practice Country
- US
- Practice Phone
- (518) 402-4333
- Enumeration Date
- February 06, 2007
- Last Updated
- June 27, 2008
- Authorized Official Last Name
- Smith
- Authorized Official First Name
- Karla
- Authorized Official Title
- Director Of Central Operations
- Authorized Official Phone
- (518) 402-4333
- Organization Subpart
- Yes
- Parent Organization Name
- STATE OF NEW YORK
- Parent Organization TIN
- <UNAVAIL>
- Taxonomies
- Intellectual Disabilities Intermediate Care Facility (315P00000X)
- Other Identifiers
- 00665729 (NY)