Organization
JULIA DYCKMAN ANDRUS MEMORIAL, INC.
Active
Other names
Andrus Childrens Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL T DEL PILAR (INTERIM CEO)
(914) 965-3700
Entity
Organization
Contact information
Practice address
19 GREENRIDGE AVE, WHITE PLAINS, NY 10605-1201
(914) 949-7680
(914) 997-7942
Mailing address
1156 N BROADWAY, YONKERS, NY 10701-1108
(914) 965-3700
(914) 965-3883
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7257001A
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355940
—
NY
01
—
050309000005
INTEGRA FIDELIS
NY
01
—
10363
HUDSON HEALTH PLAN ID
—
01
—
3191813
GHI
NY
01
—
322149
AFFINITY ID
—
Enumeration date
09/01/2005
Last updated
09/09/2020
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