1679855142 NPI number — ROCKLAND CHILDREN'S PSYCHIATRIC CENTER

Table of content: (NPI 1679855142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679855142 NPI number — ROCKLAND CHILDREN'S PSYCHIATRIC CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKLAND CHILDREN'S PSYCHIATRIC CENTER
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:
Provider Other Organization Name Type Code:
6
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:
1679855142
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 FIRST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGEBURG
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10962
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-358-8817
Provider Business Mailing Address Fax Number:
845-358-8819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 PARROTT ROAD
Provider Second Line Business Practice Location Address:
BLDG.6
Provider Business Practice Location Address City Name:
WEST NYACK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10994
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-623-0085
Provider Business Practice Location Address Fax Number:
845-627-6302
Provider Enumeration Date:
09/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MAURO
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
SOCIAL WORKER II
Authorized Official Telephone Number:
84503588817

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X , with the licence number:  2683502 , 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)





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