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General NPI Number Information
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NPI Number | 1972084366
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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 | 08/24/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | FINESON DDSOO CLINIC 80-45 WINCHESTER BLVD BLDG 80
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City | QUEENS VILLAGE
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State | NY
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Zip | 11428
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Country | US
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Telephone | 518-402-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 44 HOLLAND AVE OPWDD DIV. ENTERPRISE SOLUTIONS 4TH FL
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City | ALBANY
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State | NY
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Zip | 12229
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Country | US
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Telephone | 518-402-4333
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Fax |
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Authorized Official
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Title or Position | ASSOSCIATE COMMISSIONER
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Name | MARTHA DALTON
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Credential |
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Telephone | 518-408-2098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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