| United Cerebral Palsy Associations Of New York State Inc | |
|
Koicheff Health Care Center Dme 2324 Forest Ave Staten Island NY 10303-1506 | |
| (718) 447-8205 | |
| Not Available |
| Full Name | United Cerebral Palsy Associations Of New York State Inc |
|---|---|
| Speciality | Clinic/center |
| Location | Koicheff Health Care Center Dme, Staten Island, New York |
| Authorized Official Name and Position | Thomas Mandelkow (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 2129475770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| United Cerebral Palsy Associations Of New York State Inc 330 W 34th St Fl 15 New York NY 10001-2406 Ph: (212) 947-5770 | United Cerebral Palsy Associations Of New York State Inc Koicheff Health Care Center Dme 2324 Forest Ave Staten Island NY 10303-1506 Ph: (718) 447-8205 |
| NPI Number | 1700835394 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 09/21/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700835394 | NPI | - | NPPES |
| 00947324 | Medicaid | NY | |
| 003 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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