Organization
NEW YORK STATE
Active
Parent organization
NEW YORK STATE
Other names
CAH Finger Lakes DDSO
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW YORK STATE
Authorized official
KARLA SMITH (DIRECTOR OF CENTRAL OPERATIONS)
(518) 402-4333
Entity
Organization
Contact information
Practice address
5259 PARKSIDE DR, CANANDAIGUA, NY 14424-7507
(518) 457-9835
Mailing address
44 HOLLAND AVE, ALBANY, NY 12229-0001
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
CAH00066
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01742992
—
NY
Enumeration date
01/03/2008
Last updated
06/25/2008
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