STATE OF NEW YORK (NPI# 1275673287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275673287 |
| Entity Type | Organization |
| Organization Name | STATE OF NEW YORK |
| Other Organization Name | STATEN ISLAND DDSO 24A EXEC W |
| Practice Address |
24 O Executive Way Staten Island NY 10314 |
| Mailing Address |
44 Holland Ave Albany NY 12229-0001 |
| Practice Telephone | 5184024333 |
| Mailing Telephone | 5184024333 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2008-06-26 |
| 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 | 315P00000X | Intermediate Care Facility, Mentally Retarded | 00276639 | NY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01032315 | 05 |
| Other Name | Type Code |
|---|---|
| Staten Island DDSO 24A Exec W | 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 |
| New York State Corporations | STATE OF NEW YORK POLICE AND FIRE RETIREES ASSOCIATION OF BROOME COUNTY, INC. | P.o. Box 504, Johnson City, Ny 13790 |
| Street Address |
24 O EXECUTIVE WAY |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780863589 | Association for The Advancement of Blind and Retarded Inc | Intermediate Care Facility, Mentally Retarded | 158 Cromwell Avenue, Staten Island, NY 10304 | 2007-10-29 |
| 1134338353 | United Cerebral Palsy of New York City, Inc. | Intermediate Care Facility, Mentally Retarded | 185 Saint Marks Pl, Apts. 2l-m, Staten Island, NY 10301-1670 | 2007-05-22 |
| 1861606048 | United Cerebral Palsy of New York City Inc | Intermediate Care Facility, Mentally Retarded | 165 Saint Marks Pl, Apts 2a 2b, Staten Island, NY 10301-1669 | 2007-05-09 |
| 1073726188 | Lifespire, Inc. | Intermediate Care Facility, Mentally Retarded | 107 Jumel St, Staten Island, NY 10308-1720 | 2007-05-07 |
| 1134332257 | Lifespire, Inc. | Intermediate Care Facility, Mentally Retarded | 146 South Ave, Staten Island, NY 10303-1665 | 2007-05-07 |
| 1932322518 | United Cerebral Palsy Assoc of Nys | Intermediate Care Facility, Mentally Retarded | 35 Sharrotts Rd, Staten Island, NY 10309-1953 | 2007-04-11 |
| 1225150030 | United Cerebral Palsy Assoc of Nys Inc | Intermediate Care Facility, Mentally Retarded | 455 Medina St, Staten Island, NY 10306-4435 | 2007-04-04 |
| 1518089390 | United Cerebral Palsy Assoc of Nys | Intermediate Care Facility, Mentally Retarded | 64 Madsen Ave, Staten Island, NY 10309-2608 | 2007-04-04 |
| 1548382393 | United Cerebral Palsy Assoc of Nys | Intermediate Care Facility, Mentally Retarded | 17 Scarboro Ave, Staten Island, NY 10305-3118 | 2007-04-04 |
| 1023150398 | Eden II School for Autistic Children | Intermediate Care Facility, Mentally Retarded | 150 Granite Avenue, Staten Island, NY 10303 | 2007-02-13 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
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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.