Taconic Innovations

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

TACONIC INNOVATIONS

Practice address

872 Route 376
Wappingers Falls, NY 12590-6464

Phone

(845) 296-1042

Fax

(845) 296-0801

NPI assigned

Mar 23, 2017

Last updated

Mar 23, 2017By 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. Mathias O Oni-Eseleh Sr.

Title

Executive Director

Phone

(845) 296-1042

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1841721644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 ROUTE 376",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125906464",
            "telephone_number": "845-296-1042",
            "fax_number": "845-296-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 ROUTE 376",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125906464",
            "telephone_number": "845-296-1042",
            "fax_number": "845-296-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACONIC INNOVATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "ONI-ESELEH",
        "authorized_official_first_name": "MATHIAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "845-296-1042",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Wappingers Falls, NY
• Providers in Wappingers Falls, NY by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.