New York State Department of Health, Wadsworth Center
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Beth Israel Medical Center Clinic Gouverneur
PFI: R397 Secondary Site ID: 0007 Certification Type: WAIVER Director: Grant E Mitchell, M.D. Phone: (212) 614-2840 Fax: (212) 979-0925 Address: 109-11 Delancey St, New York, NY 10002 County: New York Country: United States Single or Primary Contact: Rosemarie Pisciotta Contact Phone: (212) 420-3987 CLIA #: 33D1053652
PFI: R397 Secondary Site ID: 0008 Certification Type: WAIVER Director: Grant E Mitchell, M.D. Phone: (718) 965-7900 Fax: (718) 965-1114 Address: 25 12th St, Brooklyn, NY 11215 County: New York Country: United States Single or Primary Contact: Rosemarie Pisciotta Contact Phone: (212) 420-3987 CLIA #: 33D1053652
PFI: R397 Secondary Site ID: 0015 Certification Type: WAIVER Director: Grant E Mitchell, M.D. Phone: (212) 636-4840 Fax: (212) 866-5741 Address: 132-140 West 125th St - 6th Fl, New York, NY 10027 County: New York Country: United States Single or Primary Contact: Rosemarie Pisciotta Contact Phone: (212) 420-3987 CLIA #: 33D1053652
PFI: R397 Secondary Site ID: 0000 Certification Type: WAIVER Director: Grant E Mitchell, M.D. Phone: (212) 774-3210 Fax: (212) 722-6234 Address: 103 E 125 Street, New York, NY 10035 County: New York Country: United States Single or Primary Contact: Rosemarie Pisciotta Contact Phone: (646) 951-7192 CLIA #: 33D1053652
PFI: R414 Secondary Site ID: 0000 Certification Type: WAIVER Director: Christopher R Cammarata, D.O. Phone: (716) 664-7353 Fax: (716) 488-2297 Address: 28 Maple Street, Jamestown, NY 14701 County: Chautauqua Country: United States Single or Primary Contact: Ronald P Hasson Contact Phone: (716) 664-7353 CLIA #: 33D1050666
PFI: R415 Secondary Site ID: 0000 Certification Type: WAIVER Director: James E Carroll, M.D. Phone: (518) 686-4105 Fax: (518) 686-3044 Address: 21 First Street, Hoosick Falls, NY 12090 County: Rensselaer Country: United States Single or Primary Contact: John Hudson Contact Phone: (518) 686-4105 CLIA #: 33D1050665
PFI: R417 Secondary Site ID: 0000 Certification Type: WAIVER Director: Romana Kulikova, M.D. Phone: (718) 317-5522 Fax: (718) 317-5919 Address: 260 Christopher Lane, Staten Island, NY 10314 County: Richmond Country: United States Single or Primary Contact: Adam Smith Contact Phone: (718) 317-5522 CLIA #: 33D1050619
PFI: R419 Secondary Site ID: 0000 Certification Type: WAIVER Director: John S Duffy, M.D. Phone: (315) 393-4700 Fax: (315) 379-4900 Address: 39 W Main Street, Canton, NY 13617 County: St. Lawrence Country: United States Single or Primary Contact: Sheila Perrigo Contact Phone: (315) 713-5025 CLIA #: 33D1050470
PFI: R427 Secondary Site ID: 0000 Certification Type: WAIVER Director: Jeanne Walker, N.P. Phone: (212) 327-8448 Fax: (212) 327-8449 Address: Hospital Bldg - 1230 York Ave, New York, NY 10065 County: New York Country: United States Single or Primary Contact: Barbara O'Sullivan, M.D. Contact Phone: (212) 327-7441 CLIA #: 33D1050725
PFI: R436 Secondary Site ID: 0000 Certification Type: WAIVER Director: Justine Magurno, M.D. Phone: (631) 648-9062 Fax: (631) 648-9069 Address: 1690 Washington Avenue - Suite A, Bohemia, NY 11716 County: Suffolk Country: United States Single or Primary Contact: Holly Seidl Michel Contact Phone: (614) 361-9509 CLIA #: 33D1050741
PFI: R439 Secondary Site ID: 0000 Certification Type: WAIVER Director: Justine Magurno, M.D. Phone: (212) 363-2650 Fax: (212) 363-2655 Address: 42 Broadway - Suite 1900, New York, NY 10004 County: New York Country: United States Single or Primary Contact: Holly Seidl Michel Contact Phone: (614) 361-9509 CLIA #: 33D1050746