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General NPI Number Information
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NPI Number | 1386851004
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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 | 05/16/2007
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | 4207 STATE HIGHWAY 220
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City | OXFORD
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State | NY
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Zip | 13830-4305
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Country | US
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Telephone | 607-843-3129
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Fax | 607-843-3199
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Provider Business Mailing Address
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Address Line | 4207 STATE HIGHWAY 220
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City | OXFORD
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State | NY
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Zip | 13830-4305
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Country | US
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Telephone | 607-843-3129
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Fax | 607-843-3199
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Authorized Official
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Title or Position | HEALTH PROGRAM ADMINISTRATOR
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Name | MS. KAREN CALLY
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Credential |
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Telephone | 518-474-2772
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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 | 0825301N
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License Number State | NY
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