Provider Demographics
NPI:1306016548
Name:SENIOR PROJECTS OF RAVENA,INC
Entity Type:Organization
Organization Name:SENIOR PROJECTS OF RAVENA,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ALBANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-756-8593
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:RAVENA
Mailing Address - State:NY
Mailing Address - Zip Code:12143-0142
Mailing Address - Country:US
Mailing Address - Phone:518-756-8593
Mailing Address - Fax:518-756-9671
Practice Address - Street 1:9 BRUNO BLOUVARD
Practice Address - Street 2:
Practice Address - City:RAVENA
Practice Address - State:NY
Practice Address - Zip Code:12143
Practice Address - Country:US
Practice Address - Phone:518-756-8593
Practice Address - Fax:518-756-9671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02857656Medicaid