Provider Demographics
NPI:1679938088
Name:UCPA OF PUTNAM AND SOUTHERN DUTCHESS COUNTIES
Entity Type:Organization
Organization Name:UCPA OF PUTNAM AND SOUTHERN DUTCHESS COUNTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSHAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-878-9078
Mailing Address - Street 1:15 MT EBO RD SOUTH
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 MOUNT EBO RD S
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4004
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:2015-12-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency