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NPI Code Detail

MEDICARE: CEREBRAL PALSY LEAGUE INC.

MEDICARE: CEREBRAL PALSY LEAGUE INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251J00000XNursing Care Agency080192NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083757256
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEREBRAL PALSY LEAGUE INC.
Provider Business Mailing Address
First Line : 61 MYRTLE ST
Second Line :
City : CRANFORD
State : NJ
Zip : 07016-3456
Country : US
Telephone Number : 908-709-1800
Fax Number :
Provider Business Practice Location Address
First Line : 373 CLERMONT TER
Second Line :
City : UNION
State : NJ
Zip : 07083-8073
Country : US
Telephone Number : 908-354-5800
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MRS. DEBRA WOLFEL
Credential :
Telephone Number : 908-709-1800
Provider Enumeration Date : 02/15/2007
Last Update Date : 08/22/2020

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Directions to “CEREBRAL PALSY LEAGUE INC. ” Practice Location

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