Organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Active
Parent organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Other names
Western NY DDSO - West Seneca
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW YORK COMPTROLLERS OFFICE
Authorized official
EARL JEFFERSON (DIRECTOR OF CENTRAL OPERATIONS)
(518) 402-4333
Entity
Organization
Contact information
Practice address
106 PINE ST, HAMBURG, NY 14075-5125
(716) 646-0048
Mailing address
44 HOLLAND AVE, ALBANY, NY 12229-0001
(518) 402-4333
(518) 473-1874
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
00229350
NY
Other
Enumeration date
06/26/2009
Last updated
01/06/2016
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