Provider Demographics
NPI:1730135757
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 BROWNSVILLE DIST
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 1:259 BRISTOL ST NYCDOHMH BROWNSVILLE DHC
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-5540
Practice Address - Country:US
Practice Address - Phone:718-495-7284
Practice Address - Fax:212-495-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002112R1338261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00247594Medicaid
NYWEM491Medicare ID - Type Unspecified