Healthcare Provider Details

I. General information

NPI: 1518172642
Provider Name (Legal Business Name): NYS OFFICE OF CHILDREN AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 WASHINGTON ST RM 122 NORTH
RENSSELAER NY
12144-2834
US

IV. Provider business mailing address

52 WASHINGTON ST RM 122 NORTH
RENSSELAER NY
12144-2834
US

V. Phone/Fax

Practice location:
  • Phone: 518-474-9560
  • Fax: 518-486-7099
Mailing address:
  • Phone: 518-474-9560
  • Fax: 518-486-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL DAVID COHEN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 518-474-9560