State of New York

NPI #1134269525 in Coram, New York

Provider Information

NPI Number
1134269525
Entity Type
Organization
Organization Name
State of New York
Subpart
Yes (part of a larger organization)
Parent Organization
STATE OF NEW YORK
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Feb 7, 2007
Last Updated
Jun 26, 2008

Practice Location

Address
85 W YAPHANK RD
City
Coram
ZIP Code
11727-4025
Phone
(518) 402-4333

Authorized Official

Name
KARLA SMITH
Title
DIRECTOR OF CENTRAL OPERATIONS
Phone
(518) 402-4333

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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