Provider Demographics
NPI:1295980092
Name:PUTNAM COUNTY CHAPTER, NYSARC, INC.
Entity type:Organization
Organization Name:PUTNAM COUNTY CHAPTER, NYSARC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMONGELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-278-7272
Mailing Address - Street 1:31 INTERNATIONAL BLVD
Mailing Address - Street 2:TERRAVEST CORPORATE PARK
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-2343
Mailing Address - Country:US
Mailing Address - Phone:845-278-7272
Mailing Address - Fax:845-278-6781
Practice Address - Street 1:125 BALDWIN PLACE RD
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-2226
Practice Address - Country:US
Practice Address - Phone:845-628-2280
Practice Address - Fax:845-628-0713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00180445DDC252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency