NPIMap

Organization Active NPI

Samaritan Daytop Village, Inc.

  • Community/Behavioral Health Agency
  • New York, NY
National Provider Identifier
1043619349
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
00245309 Issued in NY
Legal business name
SAMARITAN DAYTOP VILLAGE, INC.
Practice address
55 W 125TH St
10TH Floor
New York, NY 10027-4516
Phone
(212) 864-4128
Fax
(212) 662-9193
NPI assigned
Aug 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Authorized official

Name
Charles Madray, MBA
Title
VP of Health Services & Community B
Phone
(718) 206-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 00245309 NY Primary

Addresses

Primary practice location

55 W 125TH St
10TH Floor
New York, NY 10027-4516

Mailing address

55 W 125TH St
10TH Floor
New York, NY 10027-4516
Phone (212) 864-4128

Other identifiers 1

IdentifierTypeStateIssuer
139682283MedicaidNY

Other names 1

  • Samaritan Village Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Samaritan Village21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1043619349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W 125TH ST",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274516",
            "telephone_number": "212-864-4128",
            "fax_number": "212-662-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W 125TH ST",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274516",
            "telephone_number": "212-864-4128",
            "fax_number": "212-662-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN DAYTOP VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "MADRAY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "VP OF HEALTH SERVICES & COMMUNITY B",
        "authorized_official_telephone_number": "718-206-2000",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "00245309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139682283",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Village",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.