New York State Department of Health, Wadsworth Center
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NY Facial Surgery
PFI: W506 Secondary Site ID: 0000 Certification Type: WAIVER Director: Konstantin Vasyukevich, M.D. Phone: (212) 380-3634 Fax: (212) 380-3673 Address: 59 E 79th St - 1st Floor, New York, NY 10075 County: New York Country: United States Single or Primary Contact: Maria Kubiak Contact Phone: CLIA #: 33D2120143
PFI: W510 Secondary Site ID: 0000 Certification Type: WAIVER Director: Benjamin R Hodson, M.D. Phone: (518) 235-5431 Fax: Address: 146 Speigletown Road, Troy, NY 12182 County: Rensselaer Country: United States Single or Primary Contact: Lawrence Funk Contact Phone: (518) 937-3969 CLIA #: 33D2116658
PFI: W514 Secondary Site ID: 0000 Certification Type: WAIVER Director: Alla Goldberg, M.D. Phone: (646) 931-1000 Fax: (718) 275-0456 Address: 74-07 88th Street, Glendale, NY 11385 County: Queens Country: United States Single or Primary Contact: Miles Davis Contact Phone: (646) 931-1000 CLIA #: 33D2117603
PFI: W519 Secondary Site ID: 0000 Certification Type: WAIVER Director: Rahul Sharma, M.D. Phone: (212) 746-0885 Fax: (212) 746-5476 Address: 525 E 68th St - Rm M-101, New York, NY 10065 County: New York Country: United States Single or Primary Contact: Keith Herrera Contact Phone: (212) 746-0885 CLIA #: 33D2118451
PFI: W528 Secondary Site ID: 0000 Certification Type: PPMP Director: Kenya M Parks-Dayer, M.D. Phone: (212) 241-8015 Fax: (212) 241-2150 Address: 2351 First Ave, New York, NY 10035 County: New York Country: United States Single or Primary Contact: Kenya M Parks, M.D. Contact Phone: (212) 241-8015 CLIA #: 33D2118743
THRIVE Wellness and Recovery Inc - Lowville Commons
PFI: W531 Secondary Site ID: 0006 Certification Type: WAIVER Director: Daniel P Pisaniello, M.D. Phone: (315) 755-6563 Fax: Address: 7550 S State St, Lowville, NY 13601 County: Lewis Country: United States Single or Primary Contact: John Wilson Contact Phone: (315) 755-6563 CLIA #: 33D2118774
PFI: W531 Secondary Site ID: 0000 Certification Type: WAIVER Director: Daniel P Pisaniello, M.D. Phone: (315) 782-1777 Fax: (315) 755-2538 Address: 611 W Main St, Watertown, NY 13601 County: Jefferson Country: United States Single or Primary Contact: John Wilson Contact Phone: (315) 782-1777 CLIA #: 33D2118774
PFI: W531 Secondary Site ID: 0005 Certification Type: WAIVER Director: Daniel P Pisaniello, M.D. Phone: (315) 779-1772 Fax: (315) 782-0609 Address: 1130 State St, Watertown, NY 13601 County: Jefferson Country: United States Single or Primary Contact: John Wilson Contact Phone: (315) 779-1772 CLIA #: 33D2118774
PFI: W531 Secondary Site ID: 0004 Certification Type: WAIVER Director: Daniel P Pisaniello, M.D. Phone: (315) 788-6881 Fax: (315) 785-8410 Address: 138 Winthrop St, Watertown, NY 13601 County: Jefferson Country: United States Single or Primary Contact: John Wilson Contact Phone: (315) 788-6881 CLIA #: 33D2118774
PFI: W531 Secondary Site ID: 0003 Certification Type: WAIVER Director: Daniel P Pisaniello, M.D. Phone: (315) 788-3833 Fax: (315) 788-9155 Address: 417 Washington St, Watertown, NY 13601 County: Jefferson Country: United States Single or Primary Contact: John Wilson Contact Phone: (315) 788-3833 CLIA #: 33D2118774
PFI: W531 Secondary Site ID: 0002 Certification Type: WAIVER Director: Daniel P Pisaniello, M.D. Phone: (315) 629-4441 Fax: (315) 629-5473 Address: 24180 County Rte 16, Evans Mills, NY 13637 County: Jefferson Country: United States Single or Primary Contact: John Wilson Contact Phone: (315) 629-4441 CLIA #: 33D2118774
PFI: W561 Secondary Site ID: 0000 Certification Type: WAIVER Director: Iheanyichukwu Aja-Onu, M.D. Phone: (516) 825-2076 Fax: (516) 561-6748 Address: 3 N Main Street, Freeport, NY 11520 County: Nassau Country: United States Single or Primary Contact: Cindy Onu Contact Phone: (516) 825-2076 CLIA #: 33D2118850