Staten Island Ddso 24A Exec W

LBN: State Of New York
Staten Island Ddso 24A Exec W is an health care organization with primary practice located at 24 O Executive Way , Staten Island NY 10314. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. State Of New York can be contacted via phone (518) 402-4333, or through Smith, Karla via phone (518) 402-4333.

Contact Information

Primary practice address
24 O Executive Way Staten Island NY 10314
Phone: (518) 402-4333
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Smith, Karla
Phone: (518) 402-4333

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 00276639 New York

Profile Details

NPI number 1275673287
LBN Legal business name State Of New York
DBA Doing business as Staten Island Ddso 24A Exec W
Authorized official Smith, Karla
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 7th, 2007
Last updated Jun 26th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275673287 NPPES
New York MEDICAID 01032315

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