Organization
UNITED CEREBRAL POLSY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH PRADIEU PTA (PTA)
(718) 645-6454
Entity
Organization
Contact information
Practice address
121 LAKE ST, BROOKLYN, NY 11223-2734
(718) 645-6454
Mailing address
307 MARTENSE ST APT C7, BROOKLYN, NY 11226-4225
(718) 484-3678
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0028151
NY
Other
Enumeration date
06/13/2007
Last updated
08/22/2020
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