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General NPI Number Information
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NPI Number | 1518172642
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Entity Type | Organization
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Legal Business Name | NYS OFFICE OF CHILDREN AND FAMILY SERVICES
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 52 WASHINGTON ST RM 122 NORTH
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City | RENSSELAER
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State | NY
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Zip | 12144-2834
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Country | US
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Telephone | 518-474-9560
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Fax | 518-486-7099
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Provider Business Mailing Address
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Address Line | 52 WASHINGTON ST RM 122 NORTH
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City | RENSSELAER
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State | NY
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Zip | 12144-2834
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Country | US
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Telephone | 518-474-9560
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Fax | 518-486-7099
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL DAVID COHEN
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Credential | MD
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Telephone | 518-474-9560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number |
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License Number State |
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