PILGIRM PSYCHIATRIC CENTER SOCR 2 (NPI# 1497933048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497933048 |
| Entity Type | Organization |
| Organization Name | PILGIRM PSYCHIATRIC CENTER SOCR 2 |
| Practice Address |
998 Crooked Hill Rd West Brentwood NY 11717-1043 |
| Mailing Address |
44 Holland Ave Albany NY 12229-0001 |
| Practice Telephone | 6317613500 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2016-05-04 |
| Authorized Official Name | BETH GIARRUSSO (DIRECTOR, FINANCE) |
| Authorized Official Telephone | 5184730795 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01402193 | 05 |
| Street Address |
998 CROOKED HILL RD |
| City | WEST BRENTWOOD |
| State | NY |
| Zip Code | 11717-1043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891721916 | Herminia Hermogenes | Psychiatry & Neurology | 998 Crooked Hill Rd, Bldg. 56, West Brentwood, NY 11717-1043 | 2006-06-23 |
| 1740887124 | Christian Ciaburri | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2020-10-08 |
| 1437771011 | Noelle Vidaic | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2020-05-18 |
| 1679194112 | Maryna Krumholz | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2020-05-06 |
| 1427679695 | Christine Simcich | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2020-04-29 |
| 1538789086 | Carolyn Herold | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2020-04-24 |
| 1992325450 | Henry Vonpoleski | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2020-04-24 |
| 1851925903 | Marvett A Malcolm | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2020-02-27 |
| 1992346621 | Diane Lopez-mahabir | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2019-10-03 |
| 1770133423 | Ivan Leonidas Giannou | Registered Nurse | 998 Crooked Hill Rd, West Brentwood, NY 11717-1019 | 2019-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265998827 | Lauretta Elaine Murdock | Behavioral Analyst | C/o The Mosaic Foundation for Autism, Inc., 1725 Brentwood Rd., Brentwood, NY 11717 | 2019-02-19 |
| 1811467467 | Benjamin D. Thompkins Jr. | Social Worker | 164 3rd Avenue, Brentwood, NY 11717 | 2018-11-27 |
| 1114496262 | Timothy Eisemann | Registered Nurse | 52 Third Ave, Brentwood, NY 11717 | 2018-11-19 |
| 1245710490 | Lauren Linker | Occupational Therapist | Brentwood Union Free School District, 52 Third Avenue, Brentwood, NY 11717 | 2018-08-17 |
| 1558849786 | Anila Thomas | Registered Nurse | Pilgrims Psychiatric Center, 998 Crooked Hill Road, Brentwood, NY 11717 | 2018-07-31 |
| 1306330857 | Rhina Aguila | Licensed Practical Nurse | 162 Studley St, Brentwood, NY 11717 | 2018-06-19 |
| 1659863595 | Steven Edward Szydziak | Registered Nurse | Pilgrim State Psychiatric Center, 998crooked Hil Rd, Brentwood, NY 11717 | 2018-06-06 |
| 1881103570 | Shatevia Simpson Hickson | Behavioral Analyst | 56 Swallow Ln, Brentwood, NY 11717 | 2017-09-25 |
| 1306375753 | Shavona Layne | Behavioral Analyst | 8 Strum Streeet, Brentwood, NY 11717 | 2017-06-08 |
| 1669921334 | David Ramirez | Licensed Practical Nurse | 27 Bruce Lane, Brentwood, NY 11717 | 2016-09-23 |
| Find all providers in zip 11717 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124182035 | Pilgrim Psychiatric Center | Assisted Living Facility | 998 Crooked Hill Rd, West Brentwood, NY 11717-1043 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578911921 | Leroy Manor | Assisted Living Facility | 8678 Lake Street Road, Leroy, NY 14482 | 2016-05-26 |
| 1043679384 | Blakes Income Tax Services | Assisted Living Facility | 4509 White Plains Road, Bronx, NY 10470 | 2016-02-15 |
| 1578909594 | Tanis Phillips | Assisted Living Facility | 98 Cathedral Ln, Cheektowaga, NY 14225-4612 | 2013-05-16 |
| 1770783813 | Loretto Geriatric Community Residence | Assisted Living Facility | 750 E Brighton Ave, Syracuse, NY 13205-2201 | 2007-07-18 |
| 1861526055 | Ohel Children's Home &family Services | Assisted Living Facility | 1217 Gateway Blvd, Far Rockaway, NY 11691 | 2007-03-16 |
| 1407913619 | Capital District Psychiatric Center | Assisted Living Facility | 75 New Scotland Ave, Albany, NY 12208-3409 | 2007-01-03 |
| 1407911928 | Middletown Psychiatric Center | Assisted Living Facility | 140 Old Orangeberg Rd, Orangeberg, NY 10962 | 2006-12-26 |
| 1588033609 | Nys Office of Mental Health | Assisted Living Facility | 140 Old Orangeburg Rd, Orangeburg, NY 10962-1157 | 2015-09-18 |
| 1487057972 | Mary Agnes Manor | Assisted Living Facility | 307 Porter Ave, Buffalo, NY 14201-1031 | 2014-09-29 |
| 1740683226 | Heritage Manor of Ransomville | Assisted Living Facility | 3509 Ransomville Rd, Ransomville, NY 14131-9602 | 2014-09-29 |
| Find all providers with the same taxonomy | ||||
| City | WEST BRENTWOOD |
| Zip Code | 11717 |
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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.