The Grace Foundation of New York

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

THE GRACE FOUNDATION OF NEW YORK

Practice address

460 Brielle Ave
Staten Island, NY 10314-6427

Phone

(718) 983-3800

Fax

(718) 983-3858

NPI assigned

Dec 21, 2015

Last updated

Dec 21, 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

Donna M. Long

Title

Executive Director

Phone

(718) 983-3800

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1740645639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 BRIELLE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146427",
            "telephone_number": "718-983-3800",
            "fax_number": "718-983-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 BRIELLE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146427",
            "telephone_number": "718-983-3800",
            "fax_number": "718-983-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GRACE FOUNDATION OF NEW YORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-983-3800"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02852977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• The Medical Office of Dr. Carol M. Russell, P.C.
• The Narrows Medical Group PC (Island Medical Consultants)

• Case Management Agency in Staten Island, NY
• Providers in Staten Island, 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 Dec 21, 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.