Organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Active
Organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Active
Other names
Staten Island Developmental Disabilities Service Office Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
EARL JEFFERSON (DIRECTOR OF CENTRAL OPERATIONS)
(518) 402-4333
Entity
Organization
Contact information
Practice address
930 WILLOWBROOK RD BLDG 15L, STATEN ISLAND, NY 10314-4209
(718) 983-5369
Mailing address
44 HOLLAND AVE, ALBANY, NY 12208-3411
(518) 402-4333
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
05/08/2026
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