Organization
MIDDLETOWN PSYCHIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PUCCIO (DIRECTOR, FINANCE)
(518) 473-0795
Entity
Organization
Contact information
Practice address
122 DOROTHEA DIX DR, MIDDLETOWN, NY 10940-1907
(845) 342-5511
Mailing address
44 HOLLAND AVE, ALBANY, NY 12229-0001
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01618804
—
NY
Enumeration date
02/15/2007
Last updated
08/01/2008
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