Provider Demographics
NPI:1578745865
Name:NEW YORK FOUNDLING ICF AKA ST. AGATHA'S 6 DURYEA LANE
Entity Type:Organization
Organization Name:NEW YORK FOUNDLING ICF AKA ST. AGATHA'S 6 DURYEA LANE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:BACCAGLINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-886-4075
Mailing Address - Street 1:590 AVENUE OF THE AMERICAS
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2019
Mailing Address - Country:US
Mailing Address - Phone:212-633-9300
Mailing Address - Fax:212-886-4008
Practice Address - Street 1:6 DURYEA LN
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-3105
Practice Address - Country:US
Practice Address - Phone:845-623-3461
Practice Address - Fax:845-623-6244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities