| NPI | 1891403150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CAPRA Superintendent 914-941-0108 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |