Organization
NYSARC INC NYC CHAPTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C GOLDSMITH (CHIEF OPERATING OFFICER)
(212) 780-2692
Entity
Organization
Contact information
Practice address
16120 89TH AVE, 2B, JAMAICA, NY 11432-3901
(212) 780-2538
Mailing address
83 MAIDEN LN, 11TH FLOOR, NEW YORK, NY 10038-4812
(212) 780-2631
(212) 777-5893
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
06198492
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02915084
—
NY
01
—
06198492
NYS OMRDD
NY
Enumeration date
11/26/2007
Last updated
11/26/2007
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