CONIFER PARK, INC. (NPI# 1346296720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346296720 |
| Entity Type | Organization |
| Organization Name | CONIFER PARK, INC. |
| Practice Address |
80 Sharron Ave Plattsburgh NY 12901-4700 |
| Mailing Address |
Po Box 417153 Boston MA 02241-7153 |
| Practice Telephone | 5185611447 |
| Practice Fax Number | 5185628812 |
| Mailing Telephone | 5189528140 |
| Mailing Fax Number | 5189528287 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2017-01-30 |
| Authorized Official Name | MS. TAMMY SMITH (DIRECTOR, OP BILLING DEPT.) |
| Authorized Official Telephone | 5189528408 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01420800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730379504 | Conifer Park, Inc. | Clinic/Center | 323 Lake Hill Road, Hawley Cottage, 1st Floor, Burnt Hills, NY 12027-9772 | 2007-07-27 |
| 1235185612 | Conifer Park, Inc. | Clinic/Center | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2006-05-26 |
| 1366498768 | Conifer Park, Inc. | Clinic/Center | 526 Old Liverpool Rd, Liverpool, NY 13088-6238 | 2006-05-26 |
| 1972558179 | Conifer Park, Inc. | Clinic/Center | 55 Elm St, Glens Falls, NY 12801-3549 | 2006-05-24 |
| 1356396543 | Conifer Park, Inc. | Clinic/Center | 2435 6th Ave, Troy, NY 12180-2227 | 2006-05-24 |
| 1154652709 | Conifer Park, Inc. | Substance Abuse Rehabilitation Facility | 15 Henning Rd, F. Donald Myers Education Center, Saratoga Springs, NY 12866-3749 | 2010-01-21 |
| 1336339969 | Conifer Park, Inc. | Clinic/Center | 79 Glenridge Rd, Cottage #1, Glenville, NY 12302-4523 | 2007-07-30 |
| 1366632986 | Conifer Park, Inc. | Clinic/Center | 216 Main St, Suite #2, Hudson Falls, NY 12839-1813 | 2007-07-30 |
| 1023208139 | Conifer Park, Inc. | Clinic/Center | 1051 Dix Ave, Buildings E and G, 1st Floors, Hudson Falls, NY 12839-1053 | 2007-07-26 |
| 1649225897 | Conifer Park, Inc. | Clinic/Center | 600 Franklin St, Schenectady, NY 12305-2100 | 2006-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CONIFER PARK, INC. | 79 Glenridge Road, Glenridge, Ny 12302 |
| Street Address |
80 SHARRON AVE |
| City | PLATTSBURGH |
| State | NY |
| Zip Code | 12901-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577533 | Sydney Sturgen | Registered Nurse | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2020-10-29 |
| 1649881053 | Nicole Bordeau | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2020-08-11 |
| 1003439001 | Katrina Lopez | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2020-05-26 |
| 1164051066 | James Perales | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2020-04-03 |
| 1538705678 | Carlee Agoney | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-11-25 |
| 1982249173 | Marlene Holmes | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-11-12 |
| 1437703162 | Lee Ann Malseptic | Registered Nurse | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-07-31 |
| 1407409592 | Chad Michael Rollings | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-07-18 |
| 1033778139 | Patrick Mccormick | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-06-12 |
| 1194381590 | Nora Paola Sponable | Licensed Practical Nurse | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-05-13 |
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|---|---|---|---|---|
| 1093284721 | Get Movin Inc | Non-emergency Medical Transport (VAN) | 316 Cornelia St, 21a, Plattsburgh, NY 12901 | 2018-11-26 |
| 1528536141 | Inmaculada Ibanez-casas | Technician | Sibley Hall, 113 Rugar Street, Plattsburgh, NY 12901 | 2018-11-13 |
| 1760950372 | Martha R Wasserbauer | Dietetic Technician, Registered | Mountain View Pediatrics, 18 Feathers Drive, Plattsburgh, NY 12901 | 2018-11-13 |
| 1568958411 | Joel Cherian | Student in an Organized Health Care Education/Training Program | 159 Margaret St Ste 100, Plattsburgh, NY 12901 | 2018-07-03 |
| 1396284477 | Florence Reynaud | Acupuncturist | 135 S. Peru Street, Adirondack Integrative Wellness Center, Plattsburgh, NY 12901 | 2017-02-22 |
| 1124565783 | Mytchel Hector | Registered Nurse | 43 Hamilton Street Apt #202, Plattsburgh, NY 12901 | 2017-01-20 |
| 1780136697 | Michael Bruso | Psychologist | 5436 Peru St. Apt. 5, Plattsburgh, NY 12901 | 2016-10-26 |
| 1902357536 | Ashley Patricia Cota | Nurse Practitioner | 214 Cornelia St., Plattsburgh, NY 12901 | 2016-10-19 |
| 1255703310 | Kenneth Wayne Ackley | Licensed Practical Nurse | 16 Ampersand Drive, Plattsbugh, NY 12901 | 2015-10-28 |
| 1275949448 | Shanni Lee Hicks | Specialist | 63 Arnold Rd, Plattsburgh, NY 12901 | 2014-07-08 |
| Find all providers in zip 12901 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1588066716 | Care Counseling Center, LLC | Clinic/Center | 214 W 116th St, New York, NY 10026-2494 | 2014-09-18 |
| 1831507573 | Nathaniel Chambers | Clinic/Center | 801 Saint Anns Ave, Bronx, NY 10456-7648 | 2014-07-25 |
| 1508272238 | Trinity of Chemung County | Clinic/Center | 150 Lake St Ste 2, Elmira, NY 14901-3401 | 2014-07-02 |
| 1093074825 | Community Counseling & Mediation | Clinic/Center | 367 E 7th St, Brooklyn, NY 11218-4105 | 2012-05-14 |
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| City | PLATTSBURGH |
| Zip Code | 12901 |
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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.