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Organization
NYSARC INC NYC CHAPTER
Active
Organization
NYSARC INC NYC CHAPTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C GUNDERSON (ASSOCIATE EXECUTIVE DIRECTOR)
(212) 780-2665
Entity
Organization
Contact information
Practice address
126 E 126TH ST, APT 5B, NEW YORK, NY 10035-1702
(212) 780-2538
Mailing address
83 MAIDEN LN, 8FLOOR, NEW YORK, NY 10038-4812
(212) 780-4459
(212) 777-4277
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61980504
NYS OMRDD
NY
Enumeration date
06/04/2010
Last updated
06/04/2010
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