Provider Demographics
NPI:1609804673
Name:CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
Entity Type:Organization
Organization Name:CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
Other - Org Name:NYCDOHMH BEDFORD DISTRICT HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRALDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-396-6234
Mailing Address - Street 1:42-09 28TH STREET CN-48
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4132
Mailing Address - Country:US
Mailing Address - Phone:347-396-6234
Mailing Address - Fax:347-396-6366
Practice Address - Street 1:485 TROOP AVE
Practice Address - Street 2:NYCDOHMH BEDFORD DHC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-1037
Practice Address - Country:US
Practice Address - Phone:212-575-2459
Practice Address - Fax:212-919-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002112R5622261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00247609Medicaid
NY00247609Medicaid