Organization
ICD INTERNATIONAL CENTER FOR THE DISABLED
Active
Other names
ICD Mental Health Clinic PS 146
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LES HALPERT PHD (CEO)
(212) 585-6009
Entity
Organization
Contact information
Practice address
421 E 106TH ST, NEW YORK, NY 10029-4846
(212) 996-6127
(212) 828-8453
Mailing address
340 E 24TH ST, NEW YORK, NY 10010-4019
(212) 585-6000
(212) 585-6262
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
6704100B
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244413
—
NY
01
—
040816000080
FIDELIS CARE NEW YORK
NY
01
—
1054350
BEACON HEALTH STRATEGIES
NY
01
—
58P0081
NYPRESBY HEALTH PLAN
NY
01
—
A31902
PERFORMAX-MULTIPLAN
NY
Enumeration date
06/18/2007
Last updated
08/22/2020
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