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Organization
UPSTATE CEREBRAL PALSY, INC
Active
Organization
UPSTATE CEREBRAL PALSY, INC
Active
Other names
United Cerebral Palsy & Handicpped Persons Assn.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENO DECONDO (EXECUTIVE DIRECTOR)
(315) 724-6907
Entity
Organization
Contact information
Practice address
1002 OSWEGO ST, UTICA, NY 13502-5031
(315) 798-8868
Mailing address
125 BUSINESS PARK DR, UTICA, NY 13502-6305
(315) 724-6907
(315) 733-0791
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
213E00000X
Podiatrist
—
—
261Q00000X
Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00474180
—
NY
05
—
01039156
—
NY
05
—
07485394
—
NY
Enumeration date
05/17/2006
Last updated
04/05/2023
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