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General NPI Number Information
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NPI Number | 1710315718
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Entity Type | Organization
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Legal Business Name | CDK ABILITIES PHYSICAL THERAPY, SPEECH LANGUAGE PATHOLOGY
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 100 MAPLE STREET
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City | GLENSFALLS
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State | NY
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Zip | 12801-3602
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Country | US
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Telephone | 518-307-3494
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Fax | 518-541-2091
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Provider Business Mailing Address
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Address Line | 25 BROOKFIELD RUN
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City | QUEENSBURY
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State | NY
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Zip | 12804-8796
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Country | US
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Telephone | 518-307-3494
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Fax | 518-541-2091
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Authorized Official
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Title or Position | OWNER/PARTNER MANAGER
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Name | MRS. MELISSA M DUNBAR
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Credential | MS CCCSLP
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Telephone | 518-307-3494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 006990
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License Number State | NY
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