Healthcare Provider Details

I. General information

NPI: 1639234156
Provider Name (Legal Business Name): NYS OFFICE OF MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WARDS ISLAND
NEW YORK NY
10035
US

IV. Provider business mailing address

44 HOLLAND AVE
ALBANY NY
12229-0001
US

V. Phone/Fax

Practice location:
  • Phone: 212-369-0500
  • Fax:
Mailing address:
  • Phone: 518-473-8234
  • Fax: 518-473-5167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number StateNY

VIII. Authorized Official

Name: BETH GIARRUSSO
Title or Position: DIRECTOR, FINANCE
Credential:
Phone: 518-473-3598