Provider Demographics
NPI:1386887529
Name:ABBOTT HOUSE
Entity type:Organization
Organization Name:ABBOTT HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:VIAFORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-591-7300
Mailing Address - Street 1:100 NORTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533
Mailing Address - Country:US
Mailing Address - Phone:914-591-7300
Mailing Address - Fax:914-591-3236
Practice Address - Street 1:100 NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533
Practice Address - Country:US
Practice Address - Phone:914-591-7300
Practice Address - Fax:914-591-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01358772Medicaid