Healthcare Provider Details

I. General information

NPI: 1366499444
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: 05/27/2006
Last Update Date: 05/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 STUYVESANT PLACE NYCDOHMH RICHOMOND DHC
STATEN ISLAND NY
10301-1912
US

IV. Provider business mailing address

42-09 28TH STREET CN-48
LONG ISLAND CITY NY
11101-4132
US

V. Phone/Fax

Practice location:
  • Phone: 718-983-4502
  • Fax: 718-273-8195
Mailing address:
  • Phone: 347-396-6234
  • Fax: 347-396-6366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number7002112R1744
License Number StateNY

VIII. Authorized Official

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