1538276530 NPI number — STATE OF NEW YORK COMPTROLLERS OFFICE

Table of content: (NPI 1538276530)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538276530 NPI number — STATE OF NEW YORK COMPTROLLERS OFFICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STATE OF NEW YORK COMPTROLLERS OFFICE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HELEN HAYES HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538276530
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ROUTE 9W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST HAVERSTRAW
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10993-1127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-786-4000
Provider Business Mailing Address Fax Number:
845-947-0036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ROUTE 9W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST HAVERSTRAW
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10993-1127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-786-4000
Provider Business Practice Location Address Fax Number:
845-947-0036
Provider Enumeration Date:
08/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COLETTI
Authorized Official First Name:
EDMUND
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
845-786-4305

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  4322300N , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0014119 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02071070 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: H999014 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0022801 . This is a "BLUE CROSS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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