Fagan Residence
Fagan Residence is a healthcare organization registered as Intellectual and/or Developmental Disabilities Residential Treatment Facility in Elmont, NY, holding Type 2 (organization) NPI 1730209362 since 2007. The authorized official on file is Edwin Kennedy, Cfo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1730209362 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Fagan Residence |
| Practice address | 1504 DEPAUL ST, Elmont, NY, 11003 |
| Phone | 6316653434 |
| Enumeration date | 2007-03-29 |
| Last updated in NPPES | 2020-08-22 |
Authorized official
| Name | Edwin Kennedy |
|---|---|
| Title | Cfo |
| Phone | 5167337000 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | Primary | 6186445 | NY |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02245930 | Medicaid | NY | — |
Copy-ready billing details
Provider: Fagan Residence NPI: 1730209362 Taxonomy: 320600000X (Intellectual and/or Developmental Disabilities Residential Treatment Facility) Address: 1504 DEPAUL ST, Elmont, NY, 11003
Verify this record
Cross-check NPI 1730209362 against the authoritative CMS record: view Fagan Residence on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Fagan Residence located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-08-22.