State of New York
NPI 1356930820ActiveOrganization· Intermediate Care Facility, Intellectual Disabilities· Queens Village, NY
Intermediate Care Facility, Intellectual Disabilities in Queens Village, New York, registered in NPPES in January 2021, part of State of New York Comptrollers Office. The authorized official on file is Earl Raymond Jefferson, Director Of Central Operations.
Overview
| NPI | 1356930820 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | State of New York Comptrollers Office |
| NPI issued | Jan 11, 2021 |
| Last updated in NPPES | Jan 11, 2021 |
| Certified by provider | Dec 30, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Intermediate Care Facility, Intellectual Disabilities Primary | 315P00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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