Provider Demographics
NPI:1114270022
Name:FEDERATION OF ORGANIZATIONS FOR THE NY STATE MENTALLY DISABLED, INC.
Entity Type:Organization
Organization Name:FEDERATION OF ORGANIZATIONS FOR THE NY STATE MENTALLY DISABLED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NUZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-464-2552
Mailing Address - Street 1:7925 WINCHESTER BLVD
Mailing Address - Street 2:BUILDING 40, 2ND FLOOR
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2128
Mailing Address - Country:US
Mailing Address - Phone:718-464-2552
Mailing Address - Fax:
Practice Address - Street 1:7925 WINCHESTER BLVD
Practice Address - Street 2:BUILDING 40, 2ND FLOOR
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2128
Practice Address - Country:US
Practice Address - Phone:718-464-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health