Provider Demographics
NPI:1215183561
Name:COMMUNITY MATERNITY SERVICES
Entity Type:Organization
Organization Name:COMMUNITY MATERNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SR. MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGIUDICE
Authorized Official - Suffix:
Authorized Official - Credentials:RSM
Authorized Official - Phone:518-482-8836
Mailing Address - Street 1:27 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1416
Mailing Address - Country:US
Mailing Address - Phone:518-482-8836
Mailing Address - Fax:518-482-5805
Practice Address - Street 1:27 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1416
Practice Address - Country:US
Practice Address - Phone:518-482-8836
Practice Address - Fax:518-482-5805
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC CHARITIES OF THE DIOCESE OF ALBANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004-HERKIMER251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01079230Medicaid