# UPSTATE CEREBRAL PALSY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659525582
- **Authorized official:** MR. GENO DECONDO (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (315) 927-2092

## Contact information

- **Practice address:** 125 BUSINESS PARK DR, UTICA, NY 13502-6305
- **Practice address phone:** (315) 724-6907
- **Practice address fax:** (315) 733-0791
- **Mailing address:** 125 BUSINESS PARK DR, UTICA, NY 13502-6305
- **Mailing address phone:** (315) 724-6907
- **Mailing address fax:** (315) 733-0791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NY | Yes |

## Other

- **Enumeration date:** 11/05/2008
- **Last updated:** 04/05/2023