NPIMap

Organization Active NPI

Sus

  • Substance Abuse Rehabilitation Facility
  • New York, NY
National Provider Identifier
1114304458
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
150511551 Issued in NY
Legal business name
SUS
Practice address
170 E 107TH St
New York, NY 10029-3905
Phone
(212) 722-7507
Fax
(212) 722-7583
NPI assigned
May 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Authorized official

Name
Laura Wierbicki, LMSW
Title
Program Manager
Phone
(212) 722-7507

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 150511551 NY Primary

Addresses

Primary practice location

170 E 107TH St
New York, NY 10029-3905

Mailing address

170 E 107TH St
New York, NY 10029-3905
Phone (212) 722-7507

Other names 1

  • Palladia, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Starhill10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1114304458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E 107TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293905",
            "telephone_number": "212-722-7507",
            "fax_number": "212-722-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 E 107TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293905",
            "telephone_number": "212-722-7507",
            "fax_number": "212-722-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "WIERBICKI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "212-722-7507",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "150511551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palladia, Inc.",
            "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 May 6, 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.