Provider Demographics
NPI:1588044291
Name:NEW YORK INTEGRATED NETWORK FOR PERSONS WITH DEVELOPMENTALDISABILITIES
Entity Type:Organization
Organization Name:NEW YORK INTEGRATED NETWORK FOR PERSONS WITH DEVELOPMENTALDISABILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKUS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, MA
Authorized Official - Phone:917-993-4228
Mailing Address - Street 1:300 CADMAN PLZ W
Mailing Address - Street 2:ONE PIERREPONT PLAZA, 12TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 CADMAN PLZ W
Practice Address - Street 2:ONE PIERREPONT PLAZA, 12TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2701
Practice Address - Country:US
Practice Address - Phone:718-422-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization