NPIMap

Organization Active NPI

Samaritan Daytop Village, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Huntington Station, NY
National Provider Identifier
1831210038
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SAMARITAN DAYTOP VILLAGE, INC.
Practice address
2075 New York Ave
Huntington Station, NY 11746-3238
Phone
(631) 351-7112
Fax
(631) 351-0862
NPI assigned
Apr 3, 2007
Last updated
Apr 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Authorized official

Name
Charles Madray, MBA
Title
VP of Health Services & Community B
Phone
(718) 206-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NY Primary

Addresses

Primary practice location

2075 New York Ave
Huntington Station, NY 11746-3238

Mailing address

54 W 40TH St
New York, NY 10018-2602
Phone (212) 354-6000

Other identifiers 2

IdentifierTypeStateIssuer
00659687MedicaidNY
7002121ROtherNYDEPT OF HEALTH ART 28 CER

Other names 1

  • Daytop Village, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Samaritan Village Harlem Outpatient21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1831210038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 W 40TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100182602",
            "telephone_number": "212-354-6000",
            "fax_number": "212-382-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 NEW YORK AVE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463238",
            "telephone_number": "631-351-7112",
            "fax_number": "631-351-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN DAYTOP VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "MADRAY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "VP OF HEALTH SERVICES & COMMUNITY B",
        "authorized_official_telephone_number": "718-206-2000",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00659687",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF HEALTH ART 28 CER",
            "identifier": "7002121R",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daytop Village, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Huntington Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.