Basic Information
| Provider Information | |||||||||
| NPI: | 1033375258 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NYS OFFICE OF MENTAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 44 HOLLAND AVE | ||||||||
| Address2: | NYS OMH FINANCE | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122290001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 9005 OLD RIVER RD | ||||||||
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| City: | MARCY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134033000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157368271 | ||||||||
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| ProviderEnumerationDate: | 08/07/2008 | ||||||||
| LastUpdateDate: | 08/07/2008 | ||||||||
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| AuthorizedOfficialLastName: | PUCCIO | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 5184730795 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | Y | Hospitals | Psychiatric Hospital |
No ID Information.