Organization
STATE OF NEW YORK
Active
Parent organization
STATE OF NEW YORK
Other names
Bernard Fineson DDSO
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW YORK
Authorized official
EARL RAYMOND JEFFERSON (DIRECTOR OF CENTRAL OPERATIONS)
(518) 402-4333
Entity
Organization
Contact information
Practice address
8045 WINCHESTER BLVD BLDG 08, QUEENS VILLAGE, NY 11427-2194
(718) 217-4242
Mailing address
44 HOLLAND AVE FL 4, ALBANY, NY 12208-3411
(518) 402-4333
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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