NPIMap

Organization Active NPI

Sayville Project - Suny Stony Brook

  • Case Management Agency
  • Bohemia, NY
National Provider Identifier
1124224084
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SAYVILLE PROJECT - SUNY STONY BROOK
Practice address
640 Johnson Ave Ste 2
Bohemia, NY 11716-2624
Phone
(631) 563-2290
Fax
(631) 563-2360
NPI assigned
Jun 26, 2007
Last updated
Sep 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Authorized official

Name
Ms. Bridget Baio, LMSW
Title
Director
Phone
(631) 563-2290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

640 Johnson Ave Ste 2
Bohemia, NY 11716-2624

Mailing address

640 Johnson Ave Ste 2
Bohemia, NY 11716-2624
Phone (631) 563-2290

Other identifiers 1

IdentifierTypeStateIssuer
01571851MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
RPC-Middletown Mental Health Clinic269 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

640 Johnson Ave
Ste 2
Bohemia, NY 11716
Phone (631) 563-2290

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1124224084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JOHNSON AVE STE 2",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117162624",
            "telephone_number": "631-563-2290",
            "fax_number": "631-563-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JOHNSON AVE STE 2",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117162624",
            "telephone_number": "631-563-2290",
            "fax_number": "631-563-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAYVILLE PROJECT - SUNY STONY BROOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "BAIO",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-563-2290",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01571851",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.