Organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Active
Parent organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Other names
Taconic DDSO
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
1620 TOWN CENTER ROUTE 22, BREWSTER, NY 10509-4052
(845) 279-2905
Mailing address
44 HOLLAND AVE, ALBANY, NY 12229-0001
(518) 402-4333
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
00275410
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01399242
—
NY
Enumeration date
03/20/2007
Last updated
12/28/2015
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