NPIMap

Organization Active NPI

Richmond University Medical Center Adolescent Program

  • Community/Behavioral Health Agency
  • Staten Island, NY
National Provider Identifier
1225414329
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
7749004A Issued in NY
Legal business name
RICHMOND UNIVERSITY MEDICAL CENTER ADOLESCENT PROGRAM
Practice address
669 Castleton Ave
Staten Island, NY 10301-2028
Phone
(718) 442-2225
Fax
(718) 442-2289
NPI assigned
Jul 31, 2015
Last updated
Jul 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Authorized official

Name
Mr. Robert Ren
Title
Avp Finance
Phone
(718) 818-1380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 7749004A NY Primary

Addresses

Primary practice location

669 Castleton Ave
Staten Island, NY 10301-2028

Mailing address

669 Castleton Ave
Staten Island, NY 10301-2028
Phone (718) 442-2225

Other identifiers 1

IdentifierTypeStateIssuer
00248820MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Richmond Medical Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1225414329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012028",
            "telephone_number": "718-442-2225",
            "fax_number": "718-442-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012028",
            "telephone_number": "718-442-2225",
            "fax_number": "718-442-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND UNIVERSITY MEDICAL CENTER ADOLESCENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "REN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "AVP FINANCE",
        "authorized_official_telephone_number": "718-818-1380",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "7749004A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00248820",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.