Provider Demographics
NPI:1114641982
Name:CENTER FOR DISABILITIES INNOVATIONS
Entity Type:Organization
Organization Name:CENTER FOR DISABILITIES INNOVATIONS
Other - Org Name:CENTER FOR DISABILITIES INNOVATIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATHIAS
Authorized Official - Middle Name:O
Authorized Official - Last Name:ONI-ESELEH
Authorized Official - Suffix:
Authorized Official - Credentials:DBA
Authorized Official - Phone:845-592-4972
Mailing Address - Street 1:872 ROUTE 376
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6464
Mailing Address - Country:US
Mailing Address - Phone:845-592-4972
Mailing Address - Fax:
Practice Address - Street 1:872 ROUTE 376
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6464
Practice Address - Country:US
Practice Address - Phone:845-592-4972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty