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General NPI Number Information
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NPI Number | 1790087914
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Entity Type | Organization
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Legal Business Name | CEREBRAL PALSEY ASSOC NYS
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 2324 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-1506
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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 | 2324 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-1506
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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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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MR. RONI ZARBIV
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Credential | LCSW
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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 | 070802-1
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License Number State | NY
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