Provider Demographics
NPI:1457418337
Name:TRANSITIONAL SERVICES FOR NEW YORK, INC
Entity type:Organization
Organization Name:TRANSITIONAL SERVICES FOR NEW YORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GRUBLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:718-746-6647
Mailing Address - Street 1:1016 162ND ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2124
Mailing Address - Country:US
Mailing Address - Phone:718-746-6647
Mailing Address - Fax:
Practice Address - Street 1:9027 SUTPHIN BLVD STE 5
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3648
Practice Address - Country:US
Practice Address - Phone:718-526-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSITIONAL SERVICES FOR NEW YORK, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-02
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00739762Medicaid
NY01335AMedicare ID - Type Unspecified
NY00739762Medicaid