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General NPI Number Information
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NPI Number | 1225623572
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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 | 03/08/2021
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 470A CLARKSON AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-2012
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Country | US
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Telephone | 718-270-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 445 LENOX RD
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City | BROOKLYN
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State | NY
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Zip | 11203-2017
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Country | US
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Telephone | 718-826-4911
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | JEFFREY KOSTALOS
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Credential |
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Telephone | 718-826-4911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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