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Organization

STONY FORD FOUNDATION INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDDIE DAVILA (MEDICAID BILLER)
(845) 703-5523
Entity
Organization

Contact information

Practice address
390 CRYSTAL RUN RD, SUIT 105, MIDDLETOWN, NY 10941
(845) 703-5523
(845) 703-2970
Mailing address
390 CRYSTAL RUN RD, SUIT 105, MIDDLETOWN, NY 10941
(845) 703-5523
(845) 703-2970

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01288944
NY
05
01387728
NY
05
01489761
NY
05
01790945
NY
05
02004126
NY
05
02008111
NY
05
02205801
NY
05
02528187
NY
05
02596610
NY
05
02702087
NY
05
02751820
NY
Enumeration date
06/25/2007
Last updated
07/21/2022
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