Provider Demographics
NPI:1720325921
Name:THERACARE OF NEW YORK, INC.
Entity Type:Organization
Organization Name:THERACARE OF NEW YORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-564-2350
Mailing Address - Street 1:50 WASHINGTON ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-2710
Mailing Address - Country:US
Mailing Address - Phone:888-355-3255
Mailing Address - Fax:866-220-8701
Practice Address - Street 1:50 WASHINGTON ST
Practice Address - Street 2:SUITE 502
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-2710
Practice Address - Country:US
Practice Address - Phone:888-355-3255
Practice Address - Fax:866-220-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency