Provider Demographics
NPI:1164763348
Name:NYS OFFICE OF MENTAL HEALTH
Entity Type:Organization
Organization Name:NYS OFFICE OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARSEILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-761-2737
Mailing Address - Street 1:305 PLYMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1930
Mailing Address - Country:US
Mailing Address - Phone:516-483-6479
Mailing Address - Fax:
Practice Address - Street 1:305 PLYMOUTH CT
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-1930
Practice Address - Country:US
Practice Address - Phone:516-483-6479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040358-1323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility