New York State Department of Health, Wadsworth Center
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Amsterdam Center
PFI: R583 Secondary Site ID: 0000 Certification Type: PPMP Director: Chelsea A Faso, M.D. Phone: (212) 865-4104 Fax: (212) 864-5375 Address: 690 Amsterdam Ave, New York, NY 10025 County: New York Country: United States Single or Primary Contact: Patricia Engelhardt Contact Phone: (845) 546-8410 CLIA #: 33D1056993
PFI: R585 Secondary Site ID: 0000 Certification Type: WAIVER Director: Heidi P Cordi, M.D. Phone: (518) 328-8113 Fax: Address: 19 Town Garage Rd, East Nassau, NY 12062 County: Rensselaer Country: United States Single or Primary Contact: Mitchell Levinn Contact Phone: (518) 766-5587 CLIA #: 33D1056992
PFI: R633 Secondary Site ID: 0000 Certification Type: WAIVER Director: Ben Z Cohen, M.D. Phone: (212) 772-6830 Fax: (212) 772-6883 Address: 138-140 E 80th St, New York, NY 10075 County: New York Country: United States Single or Primary Contact: Klein Michael Contact Phone: (908) 472-0440 CLIA #: 33D1059281
Advantage Care Diagnostic Treatment Center - Feeport
PFI: R635 Secondary Site ID: 0001 Certification Type: WAIVER Director: Mary F Mulqueen, M.D. Phone: 51668644012 Fax: Address: 230 Hanse Avenue, Freeport, NY 11520 County: Nassau Country: United States Single or Primary Contact: Mary Fullam Contact Phone: (516) 686-4400 CLIA #: 33D1057847
PFI: R635 Secondary Site ID: 0000 Certification Type: WAIVER Director: Mary F Mulqueen, M.D. Phone: (516) 686-4400 Fax: (516) 629-3046 Address: 189 Wheatley Rd, Brookville, NY 11545 County: Nassau Country: United States Single or Primary Contact: Mary Fullam Contact Phone: (516) 686-4400 CLIA #: 33D1057847
PFI: R637 Secondary Site ID: 0000 Certification Type: WAIVER Director: Rose Anna G Roantree, D.O. Phone: (845) 497-3186 Fax: (845) 497-3185 Address: 7 North St, Washingtonville, NY 10992 County: Orange Country: United States Single or Primary Contact: Brian Bates Contact Phone: 845497318641 CLIA #: 33D1059107
PFI: R644 Secondary Site ID: 0000 Certification Type: WAIVER Director: Nina R Priven, M.D. Phone: (212) 523-8672 Fax: (212) 362-2110 Address: 2109 Broadway, New York, NY 10023 County: New York Country: United States Single or Primary Contact: Elizabeth Hinc Contact Phone: (212) 362-2208 CLIA #: 33D0707055
PFI: R645 Secondary Site ID: 0000 Certification Type: WAIVER Director: Brendan C O'Connor, M.D. Phone: (585) 461-0410 Fax: (585) 461-4545 Address: 1732 South Ave, Rochester, NY 14620 County: Monroe Country: United States Single or Primary Contact: Jennifer Cole Contact Phone: (585) 238-8194 CLIA #: 33D1059662
PFI: R650 Secondary Site ID: 0000 Certification Type: WAIVER Director: Scott M Glick, D.O. Phone: (315) 524-5750 Fax: (315) 524-4501 Address: 6132 Furnace Road, Ontario, NY 14519 County: Wayne Country: United States Single or Primary Contact: Timothy Brower Contact Phone: (585) 766-7597 CLIA #: 33D1063415
PFI: R656 Secondary Site ID: 0000 Certification Type: WAIVER Director: Robert A Sable, M.D. Phone: (718) 548-7900 Fax: (718) 548-8900 Address: 5500 Broadway - Suite A, Bronx, NY 10463 County: Bronx Country: United States Single or Primary Contact: Steven Housberg Contact Phone: (718) 312-3518 CLIA #: 33D1060081
PFI: R665 Secondary Site ID: 0000 Certification Type: WAIVER Director: David B Markowitz, M.D. Phone: (607) 588-7547 Fax: (607) 588-7546 Address: 60753 State Rte 30, Grand Gorge, NY 12434 County: Delaware Country: United States Single or Primary Contact: Larry VanValkenburgh Contact Phone: (607) 588-7642 CLIA #: 33D1061198
PFI: R667 Secondary Site ID: 0000 Certification Type: WAIVER Director: Calista Yong, P.A. Phone: (212) 649-2728 Fax: (212) 649-2739 Address: 300 W 57th St - 14th Fl, New York, NY 10019 County: New York Country: United States Single or Primary Contact: Vanessa Weedman Contact Phone: (615) 468-5507 CLIA #: 33D1062602
JGB Health Facilities Corporation - GuildCare Albany
PFI: R673 Secondary Site ID: 0002 Certification Type: WAIVER Director: Komal Chandan, M.D. Phone: (518) 396-3626 Fax: (518) 396-3639 Address: 30 Century Hill Dr - Suite 2, Latham, NY 12110 County: Albany Country: United States Single or Primary Contact: Monica Traczik Contact Phone: (518) 396-3626 CLIA #: 33D0720373