Healthcare Provider Details

I. General information

NPI: 1023064136
Provider Name (Legal Business Name): CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 MAUJER STREET NYCDOHMH WILLIAMSBURG DHC
BROOKLYN NY
11101
US

IV. Provider business mailing address

42-09 28TH STREET
LONG ISLAND CITY NY
11101
US

V. Phone/Fax

Practice location:
  • Phone: 718-782-5725
  • Fax: 718-388-8644
Mailing address:
  • Phone: 347-396-6234
  • Fax: 347-396-8961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number7002112R1351
License Number StateNY

VIII. Authorized Official

Name: MRS. MARITZA GIRALDO
Title or Position: BILLING DIRECTOR
Credential:
Phone: 347-396-6234