MENORAH PARK GROUP RESIDENTS (NPI# 1689815805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689815805 |
| Entity Type | Organization |
| Organization Name | MENORAH PARK GROUP RESIDENTS |
| Practice Address |
12 Jamar Drive Dewitt NY 13066 |
| Mailing Address |
12 Jamar Dr Fayetteville NY 13066-1619 |
| Practice Telephone | 3154469111 |
| Mailing Telephone | 3154469111 |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |
| Authorized Official Name | TONI COLE (OFFICE) |
| Authorized Official Telephone | 3154469111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
SPV46480 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03035921 | 05 |
| Street Address |
12 JAMAR DRIVE |
| City | DEWITT |
| State | NY |
| Zip Code | 13066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
| 1770746810 | Karrie D Damm | Marriage & Family Therapist | 7030 E Genesse St, Ste 101, Fayetteville, NY 13066 | 2008-07-09 |
| Find all providers in zip 13066 | ||||
| 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 |
|---|---|---|---|---|
| 1861009839 | Always By Your Side, Inc. | Clinic/Center | 102 Beaumont Street, Brooklyn, NY 11235-4119 | 2020-09-24 |
| 1942861042 | Sensory Tot Spot Occupational Therapy Pllc | Clinic/Center | 24 Conifer Dr, Burnt Hills, NY 12027-9706 | 2019-06-28 |
| 1972084366 | State of New York Comptrollers Office | Clinic/Center | Fineson Ddsoo Clinic, 80-45 Winchester Blvd Bldg 80, Queens Village, NY 11428 | 2018-08-24 |
| 1750877783 | Meaningful Occupational Therapy, P.C. | Clinic/Center | 21405 18th Ave Apt 3, Bayside, NY 11360-1604 | 2018-07-02 |
| 1396195079 | State of New York Comptrollers Office | Clinic/Center | 40 Bermar St, Rochester, NY 14624 | 2016-06-14 |
| 1033569736 | State of New York Comptrollers Office | Clinic/Center | 144 W Main St, Phelps, NY 14532 | 2016-06-14 |
| 1396195095 | State of New York Comptrollers Office | Clinic/Center | 164 Sullivan Street, Elmira, NY 14901 | 2016-06-14 |
| 1588014260 | State of New York Comptrollers Office | Clinic/Center | 2059 E Henrietta Rd, Rochester, NY 14623-3922 | 2016-06-14 |
| 1306291521 | Richmond Children Center | Clinic/Center | 1291 Saw Mill River Rd, Yonkers, NY 10710-2700 | 2016-04-25 |
| 1780099606 | Sensory Heights Occupational Therapy, P.C. | Clinic/Center | 1275 81st St, Brooklyn, NY 11228-3003 | 2014-06-30 |
| Find all providers with the same taxonomy | ||||
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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.