STATE OF NEW YORK (NPI# 1154460848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154460848 |
| Entity Type | Organization |
| Organization Name | STATE OF NEW YORK |
| Other Organization Name | FINGER LAKES DDSO DT |
| Practice Address |
220 Metro Park Rochester NY 14623-2612 |
| Mailing Address |
44 Holland Ave Albany NY 12229-0001 |
| Practice Telephone | 5184024333 |
| Mailing Telephone | 5184024333 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2008-06-25 |
| Authorized Official Name | KARLA SMITH (DIRECTOR OF CENTRAL OPERATIONS) |
| Authorized Official Telephone | 5184024333 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF NEW YORK |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
D0263008 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02242973 | 05 |
| Other Name | Type Code |
|---|---|
| finger lakes ddso dt | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003447012 | State of New York | Intermediate Care Facility, Mentally Retarded | 8045 Winchester Blvd Bldg 08, Queens Village, NY 11427-2194 | 2020-01-29 |
| 1053713883 | State of New York | Pharmacy | Cook St, Dannemora, NY 12929 | 2014-09-24 |
| 1336493014 | State of New York | Pharmacy | 201 Kapoor Hall, Buffalo, NY 14214-8033 | 2012-11-02 |
| 1487906368 | State of New York | Intermediate Care Facility, Mentally Retarded | 22 Sinpatch Rd, Wassaic, NY 12592-2432 | 2012-10-03 |
| 1972883171 | State of New York | Intermediate Care Facility, Mentally Retarded | 648 Leydecker Rd, West Seneca, NY 14224-3755 | 2011-08-19 |
| 1851671044 | State of New York | Intermediate Care Facility, Mentally Retarded | 650 Leydecker Road, West Seneca, NY 14224-3755 | 2011-08-19 |
| 1093093031 | State of New York | Intermediate Care Facility, Mentally Retarded | 526 Leydecker Rd, West Seneca, NY 14224-3731 | 2011-07-25 |
| 1871890590 | State of New York | Intermediate Care Facility, Mentally Retarded | 18 Sinpatch Rd, Wassaic, NY 12592-2432 | 2011-02-15 |
| 1174852909 | State of New York | Intermediate Care Facility, Mentally Retarded | 50 Cedar Lane, Wassaic, NY 12592 | 2009-12-07 |
| 1598909996 | State of New York | Intermediate Care Facility, Mental Illness | 55 Sinpatch Rd, Wassaic, NY 12592-2410 | 2009-04-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | STATE OF NEW YORK INCORPORATED | 1215 Laurel Lane, Beverly Hills, California 90210 |
| Street Address |
220 METRO PARK |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14623-2612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124478805 | State of New York Comptrollers Office | Clinic/Center | 220 Metro Park, Rochester, NY 14623-2612 | 2016-06-14 |
| 1194162438 | Donyell Michelle Carter | Occupational Therapy Assistant | 220 Metro Park, Rochester, NY 14623-2612 | 2013-05-28 |
| 1780718551 | Monroe Ddso Clinic Metro Park | Clinic/Center | 220 Metro Park, Rochester, NY 14623-2612 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235637141 | Cornerstone Dental of Henrietta | Dentist | 2104 E. Henrietta Road, Rochester, NY 14623 | 2018-01-25 |
| 1770019713 | Brenna Cavanaugh | Psychologist | 200 East River Rd., Rochester, NY 14623 | 2017-05-11 |
| 1932649522 | Annette F. Cranker | Registered Nurse | 100 Groton Parkway, Rochester, NY 14623 | 2017-03-01 |
| 1588049258 | Lisa Parnell | Nurse Practitioner | 200 East River Road, Rochester, NY 14623 | 2015-07-23 |
| 1811371610 | Deanna Phoenix | Pharmacist | Elm & Carlton Streets, Main Hospital, Roswell Park Cancer Institute, Buffalo, NY 14623 | 2015-07-13 |
| 1518340801 | Erin Wong | Counselor | 945 E. Henrietta Rd, Suite 7a, Rochester, NY 14623 | 2015-07-04 |
| 1427437490 | Sarah Beren | Counselor | 115 Metro Park, Rochester, NY 14623 | 2015-05-23 |
| 1346628930 | Bohdan Klymochko | Family Medicine | 1300 Jefferson Rd Ste 100, Rochester, NY 14623 | 2015-05-14 |
| 1306242763 | Rochester Institute of Technology | Psychiatric Unit | 1 Lomb Memorial Drive, Rochester, NY 14623 | 2014-11-13 |
| 1972904423 | Jonathan Bloom | Urology | 400 White Spruce Blvd Ste B, Rochester, NY 14623 | 2014-09-15 |
| Find all providers in zip 14623 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396195079 | State of New York Comptrollers Office | Clinic/Center | 40 Bermar St, Rochester, NY 14624 | 2016-06-14 |
| 1588014260 | State of New York Comptrollers Office | Clinic/Center | 2059 E Henrietta Rd, Rochester, NY 14623-3922 | 2016-06-14 |
| 1740455211 | Nysarc Inc | Clinic/Center | 10 Ballantyne Rd, Rochester, NY 14623-1904 | 2008-04-25 |
| 1710152699 | Nysarc Inc | Clinic/Center | 1651 Lyell Ave, Rochester, NY 14606 | 2008-04-23 |
| 1821262759 | Nysarc Inc | Clinic/Center | 2657 W Henrietta Rd, Rochester, NY 14623-2327 | 2008-04-22 |
| 1083748792 | Monroe Ddso Clinic University | Clinic/Center | 1050 University Ave, Rochester, NY 14607-1618 | 2007-03-15 |
| 1265509491 | Rochester School of The Holy Childhood | Clinic/Center | 100 Groton Pkwy, Rochester, NY 14623-4540 | 2006-11-30 |
| 1457458424 | Nysarc Inc | Clinic/Center | 2060 Brighton Henrietta Town Line Rd, Rochester, NY 14623-2792 | 2006-09-20 |
| 1093272312 | Applied Behavioral Mental Health Counseling P.c | Clinic/Center | 510 Clinton Sq, Rochester, NY 14604-1700 | 2019-02-22 |
| 1205286986 | State of New York Comptrollers Office | Clinic/Center | 2300 Buffalo Rd, Rochester, NY 14624-1360 | 2016-06-14 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.