Provider Demographics
NPI:1144806290
Name:UNITED CEREBRAL PALSY ASSOCIATIONS OF NEW YORK STATE INC
Entity type:Organization
Organization Name:UNITED CEREBRAL PALSY ASSOCIATIONS OF NEW YORK STATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDELKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-947-5770
Mailing Address - Street 1:40 RECTOR ST FL 15
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-1722
Mailing Address - Country:US
Mailing Address - Phone:212-947-5770
Mailing Address - Fax:
Practice Address - Street 1:85 BAYVILLE AVE
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11709-1629
Practice Address - Country:US
Practice Address - Phone:516-349-8808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness