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General NPI Number Information
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NPI Number | 1518619543
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Entity Type | Organization
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Legal Business Name | EASTER SEALS NEW YORK, INC.
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 402 ROGERS PKWY
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City | ROCHESTER
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State | NY
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Zip | 14617-4738
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Country | US
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Telephone | 585-957-7158
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Fax |
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Provider Business Mailing Address
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Address Line | 633 3RD AVE FL 6
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City | NEW YORK
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State | NY
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Zip | 10017-6733
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CAROL KHOURY
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Credential |
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Telephone | 212-747-4270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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