Organization
DOWNSTATE CORRECTIONAL FACILTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO MALVAROSA MD (FACILTY HEALTH SERVICES DIRECTOR)
(845) 831-6600
Entity
Organization
Contact information
Practice address
121 RED SCHOOLHOUSE RD, FISHKILL, NY 12524-2810
(845) 831-6600
(845) 831-6794
Mailing address
PO BOX 445, FISHKILL, NY 12524-0445
(845) 831-6600
(845) 831-6794
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
F336460-1
NY
302F00000X
Exclusive Provider Organization
F336460-1
NY
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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