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General NPI Number Information
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NPI Number | 1144806290
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Entity Type | Organization
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Legal Business Name | UNITED CEREBRAL PALSY ASSOCIATIONS OF NEW YORK STATE INC
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 85 BAYVILLE AVE
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City | BAYVILLE
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State | NY
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Zip | 11709-1629
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Country | US
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Telephone | 516-349-8808
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Fax |
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Provider Business Mailing Address
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Address Line | 40 RECTOR ST FL 15
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City | NEW YORK
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State | NY
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Zip | 10006-1722
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Country | US
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Telephone | 212-947-5770
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. THOMAS MANDELKOW
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Credential |
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Telephone | 212-947-5770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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