NPI 1003970906

Creedmoor Psychiatric Center

Organisation Health Maintenance Organization Queens Village, NY

Practice location

Address: 8045 Winchester Blvd, Queens Village, NY 11427-2193
Phone: (718) 464-7500
Mailing address: 44 Holland Ave, Albany, NY 12229-0001

Authorised official

Name: Robert Puccio
Title: Director, Finance
Phone: (518) 473-0795

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

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Registry record

NPI: 1003970906
Entity type: Organization
NPI issued: 22 Dec 2006
Record last updated: 1 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.