Organization
CNY DDSO ROME CLINIC - OMR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA SMITH (DIRECTOR OF CENTRAL OPERATIONS)
(518) 402-4333
Entity
Organization
Contact information
Practice address
14 ARNOLD AVE, UTICA, NY 13502-5602
(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
00273840
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01552363
—
NY
Enumeration date
03/15/2007
Last updated
08/20/2009
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