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General NPI Number Information
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NPI Number | 1356672695
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Entity Type | Organization
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Legal Business Name | CEREBRAL PALSY ASSOCIATIONS OF NEW YORK STATE
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 5140 59TH ST
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City | WOODSIDE
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State | NY
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Zip | 11377-7413
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Country | US
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Telephone | 718-639-2931
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Fax | 718-334-0399
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Provider Business Mailing Address
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Address Line | 5140 59TH ST
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City | WOODSIDE
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State | NY
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Zip | 11377-7413
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Country | US
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Telephone | 718-639-2931
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Fax | 718-334-0399
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Authorized Official
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Title or Position | SUPV. OF BEHAVIORAL HEALTH SERVICES
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Name | MS. LING CHEN CHEN
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Credential |
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Telephone | 718-447-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | P73944
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License Number State | NY
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