Provider Demographics
NPI:1255641270
Name:THE RESEARCH FOUNDATION SUNY DOWNSTATE
Entity type:Organization
Organization Name:THE RESEARCH FOUNDATION SUNY DOWNSTATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SELVADURAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-270-1178
Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:BOX 69
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2012
Mailing Address - Country:US
Mailing Address - Phone:718-270-1178
Mailing Address - Fax:718-270-1407
Practice Address - Street 1:670 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1506
Practice Address - Country:US
Practice Address - Phone:718-270-2598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22200252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency