Provider Demographics
NPI:1255837514
Name:UNITED CEREBRAL PALSY ASSOC OF NYS INC.
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY ASSOC OF NYS INC.
Other - Org Name:CEREBRAL PALSY ASSOC. OF NYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDELKOW
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:212-947-5770
Mailing Address - Street 1:330 W 34TH ST FL 15
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2488
Mailing Address - Country:US
Mailing Address - Phone:212-947-5770
Mailing Address - Fax:212-356-1348
Practice Address - Street 1:26 COLEMAN RD
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524-3936
Practice Address - Country:US
Practice Address - Phone:845-878-9078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness