Organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Active
Parent organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Other names
Finger Lakes DDSO-Parkside
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW YORK COMPTROLLERS OFFICE
Authorized official
EARL JEFFERSON (DIRECTOR OF CENTRAL OPERATION)
(518) 402-4333
Entity
Organization
Contact information
Practice address
5259 PARKSIDE DR, CANANDAIGUA, NY 14424-7507
(518) 402-4333
Mailing address
44 HOLLAND AVE, ALBANY, NY 12229
(518) 402-4333
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
00232123
NY
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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