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NPI Code Detail

MEDICARE: NYS OFFICE OF MENTAL HEALTH

MEDICARE: NYS OFFICE OF MENTAL HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0855XAdolescent and Children Mental Health Clinic/CenterNY
2261QM0850XAdult Mental Health Clinic/CenterNY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972660181
Entity Type Code : Organization
Provider Name (Legal Business Name) : NYS OFFICE OF MENTAL HEALTH
Provider Business Mailing Address
First Line : 44 HOLLAND AVE
Second Line :
City : ALBANY
State : NY
Zip : 12229-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1819 BERGEN ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11233-4513
Country : US
Telephone Number : 718-221-4500
Fax Number :
Authorized Official
Title or Position : DIRECTOR, FINANCE
Name : ROBERT PUCCIO
Credential :
Telephone Number : 518-473-0795
Provider Enumeration Date : 01/03/2007
Last Update Date : 08/12/2008

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Directions to “NYS OFFICE OF MENTAL HEALTH ” Practice Location

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