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General NPI Number Information
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NPI Number | 1376600551
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Entity Type | Organization
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Legal Business Name | UNITED CEREBRAL PALSY ASSOC OF NYS INC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | KOICHEFF HEALTH CARE CENTER 2324 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303
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Country | US
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Telephone | 718-447-0200
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Fax | 718-981-1431
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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 | 929-647-4796
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Fax | 212-356-1348
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Authorized Official
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Title or Position | EXECUTIVE VP
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Name | THOMAS MANDELKOW
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Credential |
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Telephone | 646-235-1282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NY
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