NYSARC INC NPI 1205001138

NPI Information

NPI: 1205001138
Provider Name: NYSARC INC
Classification: Clinic/Center - 261QD1600X
Specialization: Developmental Disabilities
Entity Type: Organization
Doing Business As: MONROE COUNTY CHAPTER DT FAIRPORT
CLIA Number: 33D2048292
Address: 1387 FAIRPORT RD
BUILDING 1100
FAIRPORT, NY
ZIP 14450
Phone: (585) 641-0304

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NPI Details

NYSARC INC is a developmental disabilities clinic center in Fairport, NY. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). NYSARC INC NPI is 1205001138. The provider is registered as an organization entity type.
The provider Is Doing Business As Monroe County Chapter Dt Fairport.

The provider's business location address is:

1387 FAIRPORT RD
BUILDING 1100
FAIRPORT, NY
ZIP 14450-003
Phone: (585) 641-0304

The provider's authorized official is Barbara S Wale .
The authorized official title is Coo and has the following contact phone number (585) 672-2233.

The CLIA number assigned to this NPI record is 33D2048292 - public health laboratories with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/22/2008 and was last updated on 4/22/2008.

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	261QD1600X	Clinic/Center	Developmental Disabilities	7014305	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	02287938	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: 11/21/2025

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