NPIMap

Organization Active NPI

Kelly Hannon

  • Developmentally Disabled Services Day Training Agency
  • Newburgh, NY
National Provider Identifier
1063519585
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
009353 Issued in NY
Legal business name
KELLY HANNON
Practice address
1607 Route 300
Newburgh, NY 12550-1738
Phone
(845) 564-9853
Fax
(845) 564-6974
NPI assigned
Sep 19, 2006
Last updated
Jul 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Yvonne Pasqualicchio
Title
Regional Manager
Phone
(845) 564-9853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 009353 NY Primary

Addresses

Primary practice location

1607 Route 300
Newburgh, NY 12550-1738

Mailing address

1607 Route 300
Newburgh, NY 12550-1738
Phone (845) 564-9853

Other identifiers 1

IdentifierTypeStateIssuer
009353-1OtherNYOT LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1063519585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 ROUTE 300",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125501738",
            "telephone_number": "845-564-9853",
            "fax_number": "845-564-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 ROUTE 300",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125501738",
            "telephone_number": "845-564-9853",
            "fax_number": "845-564-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY HANNON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "PASQUALICCHIO",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "845-564-9853"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NY",
            "license": "009353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "009353-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.