State of New York
Organization Active NPI Developmental Disabilities Clinic/Center · Perry, NY
NPI 1821138249 · NPPES record last updated Jun 25, 2008
Key facts
- NPI
- 1821138249
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Developmental Disabilities Clinic/Center 261QD1600X
- License
- 00277656 (NY)
- Legal business name
- STATE OF NEW YORK
- Practice address
- 7059 Standpipe DT
Perry, NY 14530 - Phone
- (518) 402-4333
- NPI assigned
- Feb 7, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- STATE OF NEW YORK
Authorized official
- Name
- Karla Smith
- Title
- Director of Central Operations
- Phone
- (518) 402-4333
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Daniel a Spengler
- Part of
- Daniel a Spengler
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | 00277656 | NY | Yes |
Addresses
Primary practice location
7059 Standpipe DT
Perry, NY 14530
Mailing address
44 Holland Ave
Albany, NY 12229-0001
Phone (518) 402-4333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01328770 | Medicaid | NY |
Other names
- craig ddso standpipe dt
Other providers in Perry, NY
- Cynthia Sue Saar
- Lori A Schofield
- Silver Lake Dental PLLC
- Southport Orthopedics and Sports Medicine
- State of New York
- State of New York Comptrollers Office
- Maria Beth Staub
- Susan Stefanon
- Lindsey Stein
- Lisa A Sutton
All providers in Perry, NY · Developmental Disabilities Clinic/Center in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.