Federation of Organizations for the Ny State Mentally Disabled Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

02155122 Issued in NY

Legal business name

FEDERATION OF ORGANIZATIONS FOR THE NY STATE MENTALLY DISABLED INC

Practice address

111 Beaver Dam Road
Brookhaven, NY 11719

Phone

(631) 286-2354

Fax

(631) 286-5289

NPI assigned

Nov 22, 2006

Last updated

Apr 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Stephen McCarthy, CPA

Title

Chief Financial Officer

Phone

(631) 669-5355

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1679648604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FARMINGDALE ROAD",
            "address_2": "ROUTE 109",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "11704",
            "telephone_number": "631-669-5355",
            "fax_number": "631-669-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEAVER DAM ROAD",
            "city": "BROOKHAVEN",
            "state": "NY",
            "postal_code": "11719",
            "telephone_number": "631-286-2354",
            "fax_number": "631-286-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERATION OF ORGANIZATIONS FOR THE NY STATE MENTALLY DISABLED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "631-669-5355",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NY",
            "license": "02155122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02155122",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noemie Daza, LMT
• Deborah Ann Deverall, LCSW
• Julianne Doughty, LMSW
• Stephanie Marie Duff
• Muhammad Umer Farooq, M.B.B.S
• Sharon Fullwood-Louis, RN
• Chris Genovese
• Ashley Nicole Gibney
• Stacy Frances Gordon
• Gurwinder K Sidhu Medical Services PC

• Case Management Agency in Brookhaven, NY
• Providers in Brookhaven, NY by specialty
• Case Management Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.