National Provider Identifier Database

NYSARC INC NYC CHAPTER
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

NYSARC INC NYC CHAPTER
55 GALLOWAY AVE
STATEN ISLAND, NY10302-2527
Phone: 212-780-2631
Fax: 212-777-5893
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for NYSARC INC NYC CHAPTER

NPI Number 1477620581
Legal business name
LBN
NYSARC INC NYC CHAPTER
Authorized official ROBERT GOLDSMITH - (CHIEF OPERATING OFFICER)
Entity Organization
Organization subpart No
Enumeration date 11/30/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • NY Medicaid: 00356794
  • NY Other: 6198444 NYS OMRDD OPERATING CERT

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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