State Of New York Comptrollers Office
Clinic/Center, Developmental Disabilities in Phelps, NY. Organization (NPI-2).
NPI number1033569736
StatusActive
Last updated in NPPESJun 14, 2016
Details
- NPI
- 1033569736
- Entity type
- Organization (NPI-2)
- Legal business name
- State Of New York Comptrollers Office
- Organization subpart
- Yes
- Enumeration date
- Jun 14, 2016
- Last updated
- Jun 14, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD1600X | Clinic/Center, Developmental Disabilities | 00232123 | NY | Yes |
Other names
- Finger Lakes Ddso-144 W Main (Other Name)
Practice location
144 W Main StPhelps, NY 14532
Phone 510-402-4333
Mailing address
44 Holland AveAlbany, NY 12229
Phone 518-402-4333
Authorized official
Earl Jefferson
Director Of Central Operations
5184024333
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