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WHITNEY YOUNG HEALTH
NPI 1073960100
Clinic/Center - Federally Qualified Health Center (FQHC) in Watervliet, NY

Active since May 18, 2016CLIA Certified · 2 labs
1804 2ND AVE, WATERVLIET, NY 12189(518) 833-6900(518) 833-6919 Get Directions Write a Review

NPPES record last updated: June 5, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 5, 2017, May 18, 2016 (2 updates tracked since 2016).

About Whitney Young Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WHITNEY YOUNG HEALTH (NPI 1073960100) is a healthcare organization registered as a federally qualified health center (fqhc) in Watervliet, New York and active in the NPI registry since May 2016. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Mary Connolly, Cfo, as its authorized official.

NPPES Registry Identity

NPI1073960100
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameWHITNEY M YOUNG JR. HEALTH CENTER, INC
Location Address1804 2ND AVEWatervliet, NY 12189-2818
Mailing Address920 Lark DrAlbany, NY 12207-1300 · (518) 465-4771 · Fax (518) 242-4784
Phone(518) 833-6900
Fax(518) 833-6919
Organization SubpartNo
Authorized OfficialMary ConnollyCfo · (518) 465-4771
Enumeration DateMay 18, 2016
Last NPPES UpdateJune 5, 20172 updates tracked since enumeration
✔ NPI 1073960100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedDentistTaxonomy 122300000X
Also ListedFamily MedicineTaxonomy 207Q00000X
1804 2ND AVE, Watervliet, NY 12189
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Other Names 1

Other NameWhitney Young Health

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
33D2112206
Facility Type
Federally Qualified Health Center
Certificate Effective Date
September 27, 2022
Certificate Expiration Date
March 26, 2027
Laboratory Director
DR. DEBORAH A. VASQUEZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Whitney Young Health to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for WHITNEY YOUNG HEALTH

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Frequently Asked Questions

What is WHITNEY M YOUNG JR. HEALTH CENTER, INC's NPI number?

The NPI number assigned to this healthcare provider is 1073960100, enumerated as an "organization" on May 18, 2016.

Where is the provider located?

The provider is located at 1804 2ND AVE WATERVLIET, NY 12189 and the phone number is (518) 833-6900.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).