State of New York

NPI #1083899702 in Tupper Lake, New York

Provider Information

NPI Number
1083899702
Entity Type
Organization
Organization Name
State of New York
Subpart
Yes (part of a larger organization)
Parent Organization
STATE OF NEW YORK
Primary Specialty
Case Management
Enumeration Date
Dec 31, 2007
Last Updated
Jul 21, 2015

Practice Location

Address
2445 STATE ROUTE 30
ZIP Code
12986-2502
Phone
(518) 457-9835

Authorized Official

Name
EARL JEFFERSON
Title
DIRECTOR OF CENTRAL OPERATIONS
Phone
(518) 402-4333

Specialties & Taxonomy Codes

Specialty
Case Management

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