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General NPI Number Information
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NPI Number | 1467817221
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Entity Type | Organization
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Legal Business Name | NYS OMH
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 998 CROOKED HILL RD BUILDING 47
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City | WEST BRENTWOOD
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State | NY
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Zip | 11717-1019
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Country | US
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Telephone | 631-761-2289
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Fax |
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Provider Business Mailing Address
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Address Line | 998 CROOKED HILL RD BUILDING 47
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City | WEST BRENTWOOD
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State | NY
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Zip | 11717-1019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DIANA JAPNGIE
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Credential |
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Telephone | 631-761-2332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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