Provider Demographics
NPI:1790713766
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 HYGIENE
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 1:42-09 28TH STREET
Mailing Address - Street 2:CN-48
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:347-396-8961
Practice Address - Street 1:6710 ROCKAWAY BEACH BLVD
Practice Address - Street 2:NYCDOHMH FAR ROCKAWAY HEALTH CENTER
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11692
Practice Address - Country:US
Practice Address - Phone:718-474-2100
Practice Address - Fax:718-945-2596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002112R1654261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00247549Medicaid
NY00247549Medicaid