Provider Demographics
NPI:1659327674
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:NEW YORK CITY DEPARTMENT OF HEALTH & MENTAL HYGIENES MANHATTANVILLE H
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:MRS
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 1:21 OLD BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4006
Mailing Address - Country:US
Mailing Address - Phone:212-442-8468
Mailing Address - Fax:
Practice Address - Street 1:21 OLD BROADWAY
Practice Address - Street 2:NYCDOHMH MANHATTANVILLE HEALTH CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-2570
Practice Address - Country:US
Practice Address - Phone:212-232-2723
Practice Address - Fax:212-232-2590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002112R1537261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00747636Medicaid