MEDICARE: NYS OFFICE OF MENTAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568526739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYS OFFICE OF MENTAL HEALTH

Provider Business Mailing Address
First Line	:	44 HOLLAND AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12229-0001
Country	:	US
Telephone Number	:	518-473-8234
Fax Number	:	518-473-5167

Provider Business Practice Location Address
First Line	:	1051 RIVERSIDE DR
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1007
Country	:	US
Telephone Number	:	212-543-5000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, FINANCE
Name	:	BETH GIARRUSSO
Credential	:
Telephone Number	:	518-473-3598

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	04/10/2017

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Directions to “NYS OFFICE OF MENTAL HEALTH ” Practice Location

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