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FINGER LAKES DDSO NPI 1558495374


NPI Information

NPI: 1558495374
Provider Name: FINGER LAKES DDSO
Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
1083 WATERLOO GENEVA RD
WATERLOO, NY
ZIP 13165
Phone: (518) 402-4333
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FINGER LAKES DDSO is a developmental disabilities clinic center in Waterloo, 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.). FINGER LAKES DDSO NPI is 1558495374. The provider is registered as an organization entity type.

The provider's business location address is:

1083 WATERLOO GENEVA RD
WATERLOO, NY
ZIP 13165-202
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 3/15/2007 and was last updated on 8/31/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QD1600XClinic/CenterDevelopmental Disabilities00272950NEW YORKYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101433807MEDICAIDNEW 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: 11/14/2023

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