STATE OF NEW YORK (NPI# 1962579235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962579235 |
| Entity Type | Organization |
| Organization Name | STATE OF NEW YORK |
| Other Organization Name | IBR SPECIALTY CLINICAL LABORATORIES |
| Practice Address |
1050 Forest Hill Rd Staten Island NY 10314-6356 |
| Practice Telephone | 7184945345 |
| Practice Fax Number | 7184940694 |
| Mailing Telephone | 7184945345 |
| Mailing Fax Number | 7184940694 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2009-02-25 |
| Authorized Official Name | DR. EDMUND C. JENKINS (LAB DIRECTOR) |
| Authorized Official Telephone | 7184945236 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 7097M040 | NY | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CLIA | 33D0860102 | 01 | |
| NY | 00782518 | 05 | |
| NY | NYS LAB LICENSE | 7097M040 | 01 |
| Other Name | Type Code |
|---|---|
| IBR Specialty Clinical Laboratories | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003447012 | State of New York | Intermediate Care Facility, Mentally Retarded | 8045 Winchester Blvd Bldg 08, Queens Village, NY 11427-2194 | 2020-01-29 |
| 1053713883 | State of New York | Pharmacy | Cook St, Dannemora, NY 12929 | 2014-09-24 |
| 1336493014 | State of New York | Pharmacy | 201 Kapoor Hall, Buffalo, NY 14214-8033 | 2012-11-02 |
| 1487906368 | State of New York | Intermediate Care Facility, Mentally Retarded | 22 Sinpatch Rd, Wassaic, NY 12592-2432 | 2012-10-03 |
| 1972883171 | State of New York | Intermediate Care Facility, Mentally Retarded | 648 Leydecker Rd, West Seneca, NY 14224-3755 | 2011-08-19 |
| 1851671044 | State of New York | Intermediate Care Facility, Mentally Retarded | 650 Leydecker Road, West Seneca, NY 14224-3755 | 2011-08-19 |
| 1093093031 | State of New York | Intermediate Care Facility, Mentally Retarded | 526 Leydecker Rd, West Seneca, NY 14224-3731 | 2011-07-25 |
| 1871890590 | State of New York | Intermediate Care Facility, Mentally Retarded | 18 Sinpatch Rd, Wassaic, NY 12592-2432 | 2011-02-15 |
| 1174852909 | State of New York | Intermediate Care Facility, Mentally Retarded | 50 Cedar Lane, Wassaic, NY 12592 | 2009-12-07 |
| 1598909996 | State of New York | Intermediate Care Facility, Mental Illness | 55 Sinpatch Rd, Wassaic, NY 12592-2410 | 2009-04-29 |
| Street Address |
1050 FOREST HILL RD |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-6356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093774804 | Milen Velinov | Medical Genetics | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2006-03-21 |
| 1831711316 | Tina Rovito Gomez | Psychologist | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2020-05-07 |
| 1578955092 | Judith Gardner | Psychologist | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2015-02-19 |
| 1477891125 | Molly Frances Wood | Genetic Counselor, MS | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2013-01-30 |
| 1407101389 | Anne Gordon | Specialist | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2012-07-17 |
| 1326347600 | Darlynne Ada Devenny | Speech-Language Pathologist | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2011-03-25 |
| 1255647319 | Instittue for Basic Research (nys Opwdd) | Early Intervention Provider Agency | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2010-08-27 |
| 1891921953 | Charles S Holburn | Behavioral Analyst | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2009-06-03 |
| 1366696437 | Maripaz Gonzalez | Pediatrics | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2008-11-15 |
| 1285831032 | Nancy Zellers | Genetic Counselor, MS | 1050 Forest Hill Rd, Staten Island, NY 10314-6356 | 2007-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942684659 | Syntegra Services Inc | Clinical Medical Laboratory | 310 Poillon Ave, Staten Island, NY 10312-5947 | 2015-07-13 |
| 1235477795 | Geno-path Diagnostic Labs, Inc | Clinical Medical Laboratory | 211 Westwood Ave, Staten Island, NY 10314-5414 | 2013-01-17 |
| 1871723312 | Precise Diagnostics, Inc. | Clinical Medical Laboratory | 294 New Dorp Ln, Staten Island, NY 10306-3036 | 2009-07-17 |
| 1194971085 | Lincoln Diagnostics LLC | Clinical Medical Laboratory | 37 Josephine St, Ste. A1, Staten Island, NY 10314-4032 | 2008-08-12 |
| 1699938977 | Medix Labs Inc | Clinical Medical Laboratory | 500 St. George Road, Staten Island, NY 10306 | 2008-07-07 |
| 1164568002 | Immune Therapy Products, LLC | Clinical Medical Laboratory | 25 Morningstar Rd, Staten Island, NY 10303-2808 | 2007-01-29 |
| 1174684856 | Quest Diagnostics | Clinical Medical Laboratory | 42 Michael Loop, Staten Island, NY 10301-4639 | 2006-12-13 |
| 1245773829 | Todt Hill Digestive Medical Disease, PC | Clinical Medical Laboratory | 78 Todt Hill Road, Suite 301, Staten Island, NY 10314-4536 | 2016-11-30 |
| 1851699615 | Metropolitan Specialty Labs, Inc | Clinical Medical Laboratory | 1551 Richmond Rd, Suite#101, Staten Island, NY 10304 | 2011-03-03 |
| 1245423508 | North Shore Diagnostic Medical Testing PC | Clinical Medical Laboratory | 2435 Victory Blvd, Staten Island, NY 10314 | 2007-08-21 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on STATE OF NEW YORK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.