Organization
STATE OF NEW YORK
Active
Parent organization
STATE OF NEW YORK
Other names
finger lakes ddso dt
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF NEW YORK
Authorized official
KARLA SMITH (DIRECTOR OF CENTRAL OPERATIONS)
(518) 402-4333
Entity
Organization
Contact information
Practice address
220 METRO PARK, ROCHESTER, NY 14623-2612
(518) 402-4333
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
D0263008
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02242973
—
NY
Enumeration date
02/06/2007
Last updated
06/25/2008
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