STATE OF NEW YORK NPI 1023159563

NPI Information

NPI: 1023159563
Provider Name: STATE OF NEW YORK

Other Name: WASSAIC DC MAPLE ICF

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
70 SINPATCH RD
WASSAIC, NY
ZIP 12592
Phone: (518) 402-4333
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STATE OF NEW YORK is an intermediate care facility mentally retarded in Wassaic, NY. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. STATE OF NEW YORK NPI is 1023159563. The provider is registered as an organization entity type.
The provider Other Name Is Wassaic Dc Maple Icf.

The provider's business location address is:

70 SINPATCH RD
WASSAIC, NY
ZIP 12592
Phone: (518) 402-4333

The provider's authorized official is Karla Smith .
The authorized official title is Director Of Central Operations and has the following contact phone number (518) 402-4333.

The enumeration date for this NPI number is 2/9/2007 and was last updated on 6/26/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		00276639	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01032246	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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