New York State Department of Health, Wadsworth Center
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St Nicholas Houses Child Health Center
PFI: R163 Secondary Site ID: 0013 Certification Type: WAIVER Director: Faisal M. Huq Ronny, M.D., Ph.D. Phone: (212) 865-1300 Fax: (212) 865-9734 Address: 281 West 127th St, New York, NY 10027 County: New York Country: United States Single or Primary Contact: Tshering Sherpa Contact Phone: (443) 373-3591 CLIA #: 33D1038410
PFI: R168 Secondary Site ID: 0000 Certification Type: PPMP Director: Michael R. Bagner, M.D. Phone: (212) 641-4500 Fax: (212) 641-4510 Address: 262 W 53rd St, New York, NY 10019 County: New York Country: United States Single or Primary Contact: Johanna Franco-botex Contact Phone: (212) 641-4505 CLIA #: 33D1037145
PFI: R169 Secondary Site ID: 0000 Certification Type: WAIVER Director: Ritchell R Dignam, M.D. Phone: (347) 215-0979 Fax: (212) 290-3086 Address: 5 Pennsylvania Place, 20th Fl, New York, NY 10001 County: New York Country: United States Single or Primary Contact: Kennya DiLegge Contact Phone: (347) 215-0979 CLIA #: 33D1055326
PFI: R170 Secondary Site ID: 0011 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 734-2264 Fax: (607) 767-0340 Address: 3344 Chambers Rd, Horseheads, NY 14845 County: Chemung Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0000 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 937-9971 Fax: (607) 937-3385 Address: 130 Centerway, Corning, NY 14830-2255 County: Steuben Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0015 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 735-1750 Fax: (607) 735-1198 Address: One Park Place, Elmira, NY 14901 County: Chemung Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (607) 734-3929 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0013 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 776-2419 Fax: (607) 776-2512 Address: 7603 NY Rte 54 - Suite 201, Bath, NY 14810 County: Steuben Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0010 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 565-9975 Fax: (607) 565-2683 Address: 29 N Chemung St, Waverly, NY 14892 County: Tioga Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0008 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 973-8000 Fax: Address: 3 Guthrie Dr, Corning, NY 14830 County: Steuben Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0007 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 734-3929 Fax: (607) 734-0781 Address: 1336 Cedar Street, Elmira, NY 14904 County: Chemung Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0006 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 687-6101 Fax: (607) 687-5994 Address: 1246 State Rte 38, Owego, NY 13827 County: Tioga Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0004 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 937-4900 Fax: (607) 937-4940 Address: 9768 Liberty Drive, Painted Post, NY 14870 County: Steuben Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R170 Secondary Site ID: 0003 Certification Type: PPMP Director: Philip A Heavner, M.D. Phone: (607) 795-5100 Fax: (607) 739-3632 Address: 31 Arnot Rd - Suite A, Horseheads, NY 14845 County: Chemung Country: United States Single or Primary Contact: Tonya Wilhelm Contact Phone: (570) 887-5087 CLIA #: 33D0174278
PFI: R171 Secondary Site ID: 0010 Certification Type: WAIVER Director: Alan Roth, M.D. Phone: (718) 206-9888 Fax: (718) 206-3033 Address: 111-20 Merrick Blvd, St Albans, NY 11433 County: Queens Country: United States Single or Primary Contact: Frederick Beekman Contact Phone: (718) 297-1699 CLIA #: 33D1037535
PFI: R171 Secondary Site ID: 0009 Certification Type: WAIVER Director: Alan Roth, M.D. Phone: (718) 641-8207 Fax: (718) 845-5287 Address: 91-20 Atlantic Avenue, Ozone Park, NY 11421 County: Queens Country: United States Single or Primary Contact: Frederick Beekman Contact Phone: (718) 663-1028 CLIA #: 33D1037535
PFI: R171 Secondary Site ID: 0007 Certification Type: WAIVER Director: Alan Roth, M.D. Phone: (718) 323-3589 Fax: (718) 323-3592 Address: 156-10 Cross Bay Blvd, Howard Beach, NY 11414 County: Queens Country: United States Single or Primary Contact: Frederick Beekman Contact Phone: (718) 508-2080 CLIA #: 33D1037535