Healthcare Provider Details

I. General information

NPI: 1891403150
Provider Name (Legal Business Name): NYS DOCCS SING SING CORRECTIONAL FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 HUNTER STREET ATTENTION: PHARMACY
OSSINING NY
10562
US

IV. Provider business mailing address

354 HUNTER STREET ATTENTION: PHARMACY
OSSINING NY
10562
US

V. Phone/Fax

Practice location:
  • Phone: 914-941-0108
  • Fax:
Mailing address:
  • Phone: 914-941-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL CAPRA
Title or Position: SUPERINTENDENT
Credential:
Phone: 914-941-0108