Prasad Children'S Dental Heath Program, Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5254200R Issued in NY

Legal business name

PRASAD CHILDREN'S DENTAL HEATH PROGRAM, INC

Practice address

465 Brickman Rd
Hurleyville, NY 12747-6002

Phone

(845) 434-0376

Fax

(845) 434-1791

NPI assigned

Jul 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Maria Cecilia Escarra

Title

Program Administrator

Phone

(845) 434-0376

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1013937143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 BRICKMAN RD",
            "city": "HURLEYVILLE",
            "state": "NY",
            "postal_code": "127475314",
            "telephone_number": "845-434-0376",
            "fax_number": "845-434-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 BRICKMAN RD",
            "city": "HURLEYVILLE",
            "state": "NY",
            "postal_code": "127476002",
            "telephone_number": "845-434-0376",
            "fax_number": "845-434-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRASAD CHILDREN'S DENTAL HEATH PROGRAM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "ESCARRA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "CECILIA",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "845-434-0376",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "5254200R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02052284",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anneliese Hartman, MS, BCBA
• Carol Ingrassia, CASAC
• Rochel Leah Klahr
• Kaitlin Elizabeth Lacey, LMSW
• Kaitlin E Parks, OTR/L
• Sullivan Paramedicine, Inc
• Jane L Swift-Senor
• Ashley Wallgren
• Doris Young

• Dental Clinic/Center in Hurleyville, NY
• Providers in Hurleyville, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.