Basic Information
| Provider Information | |||||||||
| NPI: | 1356672695 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CEREBRAL PALSY ASSOCIATIONS OF NEW YORK STATE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5140 59TH ST | ||||||||
| Address2: | |||||||||
| City: | WOODSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113777413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186392931 | ||||||||
| FaxNumber: | 7183340399 | ||||||||
| Practice Location | |||||||||
| Address1: | 5140 59TH ST | ||||||||
| Address2: | |||||||||
| City: | WOODSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113777413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186392931 | ||||||||
| FaxNumber: | 7183340399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2010 | ||||||||
| LastUpdateDate: | 01/27/2010 | ||||||||
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| AuthorizedOfficialLastName: | CHEN | ||||||||
| AuthorizedOfficialFirstName: | LING | ||||||||
| AuthorizedOfficialMiddleName: | CHEN | ||||||||
| AuthorizedOfficialTitleorPosition: | SUPV. OF BEHAVIORAL HEALTH SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 7184470200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | P73944 | NY | Y | Agencies | Community/Behavioral Health |
No ID Information.