Provider Demographics
NPI:1467480426
Name:CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
Entity type:Organization
Organization Name:CITY OF NEW YORK OFFICE OF PAYROLL ADMINISTRATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRALDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-396-6234
Mailing Address - Street 1:42-09 28TH STREET
Mailing Address - Street 2:
Mailing Address - City:LIC
Mailing Address - State:NY
Mailing Address - Zip Code:11101
Mailing Address - Country:US
Mailing Address - Phone:347-396-6234
Mailing Address - Fax:347-396-6366
Practice Address - Street 1:1826 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6601
Practice Address - Country:US
Practice Address - Phone:718-466-2214
Practice Address - Fax:718-299-7418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002476181191261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00247618Medicaid
NYWEN071Medicare ID - Type Unspecified