Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

State of New York

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1275673287

State of New York is an Intellectual Disabilities Intermediate Care Facility in Staten Island, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
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Practice location Address checks out

24 O Executive Way
Staten Island, NY 10314
Phone: (518) 402-4333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X · Licence 00276639 (NY)

Record details

NPI number1275673287
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationState of New York
Authorized official Karla Smith — Director Of Central Operations · (518) 402-4333
Other names Staten Island Ddso 24a Exec W
NPI enumeratedFebruary 7, 2007
Last updated in NPPESJune 26, 2008
Mailing address44 Holland Ave, Albany, NY 12229-0001

Other providers in Staten Island