Provider Demographics
NPI:1821768367
Name:STATE OF NEW YORK COMPTROLLERS OFFICE
Entity Type:Organization
Organization Name:STATE OF NEW YORK COMPTROLLERS OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CENTRAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-402-4333
Mailing Address - Street 1:44 HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3411
Mailing Address - Country:US
Mailing Address - Phone:518-402-4333
Mailing Address - Fax:
Practice Address - Street 1:26 CENTER CIR
Practice Address - Street 2:
Practice Address - City:WASSAIC
Practice Address - State:NY
Practice Address - Zip Code:12592-2637
Practice Address - Country:US
Practice Address - Phone:845-877-6821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NYS OPWDD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health