1811925605 NPI number — CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION

Table of content: (NPI 1811925605)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811925605 NPI number — CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
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:
NYCDOH MORRISANIA DIST CTR
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:
1811925605
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
42-09 28TH STREET
Provider Second Line Business Mailing Address:
CN-48
Provider Business Mailing Address City Name:
LIC
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11101-4132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-396-6299
Provider Business Mailing Address Fax Number:
347-396-6367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1309 FULTON AVENUE
Provider Second Line Business Practice Location Address:
NYCDOHMH MORRISANIA DHC
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10456-2403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-588-2612
Provider Business Practice Location Address Fax Number:
718-992-2889
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ELLIS
Authorized Official First Name:
JANET
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PATIENT BILING
Authorized Official Telephone Number:
347-396-6299

Provider Taxonomy Codes

  • Taxonomy code: 261QP0905X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00247627 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com