Provider Demographics
NPI:1962459057
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 JAMAICA DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PATIENT BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-396-6299
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:347-396-6299
Mailing Address - Fax:347-396-6367
Practice Address - Street 1:9037 PARSONS BLVD
Practice Address - Street 2:NYCDOHMH JAMAICA DHC
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6032
Practice Address - Country:US
Practice Address - Phone:718-262-5531
Practice Address - Fax:212-297-6885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00247549Medicaid
NY01056AMedicare PIN
NY01056GMedicare ID - Type Unspecified