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General NPI Number Information
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NPI Number | 1184621724
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Entity Type | Organization
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Legal Business Name | STATE OF NEW YORK COMPTROLLERS OFFICE
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 04/06/2012
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Provider Practice Location Address
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Address Line | 100 PATRIOTS RD
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City | STONY BROOK
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State | NY
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Zip | 11790-3318
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Country | US
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Telephone | 631-444-8500
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Fax | 631-444-8575
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Provider Business Mailing Address
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Address Line | 100 PATRIOTS RD
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City | STONY BROOK
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State | NY
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Zip | 11790-3318
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Country | US
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Telephone | 631-444-8500
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Fax | 631-444-8575
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. FRED SGANGA
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Credential |
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Telephone | 631-444-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 5151310N
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License Number State | NY
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