Provider Demographics
NPI:1467741793
Name:ORANGE CTNY DEPT. OF HEALTH EICM
Entity Type:Organization
Organization Name:ORANGE CTNY DEPT. OF HEALTH EICM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMISSIONER OF HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, MPH, PHDC
Authorized Official - Phone:845-360-6603
Mailing Address - Street 1:124 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2124
Mailing Address - Country:US
Mailing Address - Phone:845-360-6600
Mailing Address - Fax:845-291-2341
Practice Address - Street 1:124 MAIN STREET
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2124
Practice Address - Country:US
Practice Address - Phone:845-360-6600
Practice Address - Fax:845-291-2341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02960983Medicaid