Provider Demographics
NPI:1790997070
Name:ROCKLAND COUNTY CHAPTER NYSARC
Entity Type:Organization
Organization Name:ROCKLAND COUNTY CHAPTER NYSARC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHIONDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-267-2500
Mailing Address - Street 1:25 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-1401
Mailing Address - Country:US
Mailing Address - Phone:845-267-2500
Mailing Address - Fax:845-267-2109
Practice Address - Street 1:336 BUENA VISTA RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2118
Practice Address - Country:US
Practice Address - Phone:845-267-2500
Practice Address - Fax:845-267-2109
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKLAND COUNTY CHAPTER NYSARC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-07
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01212248315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01212248Medicaid