Organization · Type 2 NPI

State of New York Comptrollers Office

Developmental Disabilities Clinic/Center · Staten Island, NY

NPI number 1750469912 Active

Practice location

1050 Forest Hill Rd
Staten Island, NY 10314-6356

Call (718) 494-5151 Map

Fax (718) 494-2258

Mailing address

44 Holland Avenue
Albany, NY 12229-0001

Specialties and licenses

Taxonomy	Code	License
Developmental Disabilities Clinic/Center Primary	261QD1600X	224141 (NY)

Developmental Disabilities Clinic/Center: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

26 other providers at this address

Other developmental disabilities clinic/center providers in Staten Island

See all in Staten Island →

NPI record

NPI: 1750469912
Entity type: Organization (Type 2)
Issued: Nov 2, 2006
Last updated: Dec 28, 2015
Status: Active
Subpart: Yes of State of New York Comptrollers Office

Other names

<unavail>
Ibr George A Jervis Clinic · other name

Authorized official

Earl Jefferson
Director of Central Operations
(518) 402-4333

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1750469912

State of New York Comptrollers Office's National Provider Identifier is 1750469912, issued on Nov 2, 2006. The primary taxonomy on file is Developmental Disabilities Clinic/Center (261QD1600X), and the practice location is in Staten Island, NY. The record was last updated on Dec 28, 2015.