Provider Demographics
NPI:1932394301
Name:FINGER LAKES UNITED CEREBRAL PALSY, INC.
Entity type:Organization
Organization Name:FINGER LAKES UNITED CEREBRAL PALSY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT CLINICAL SER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-334-6000
Mailing Address - Street 1:731 PRE EMPTION RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1335
Mailing Address - Country:US
Mailing Address - Phone:585-394-9510
Mailing Address - Fax:
Practice Address - Street 1:731 PRE EMPTION RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1335
Practice Address - Country:US
Practice Address - Phone:585-394-9510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013962251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)