Organization
UPSTATE CEREBRAL PALSY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GENO DECONDO (EXECUTIVE DIRECTOR)
(315) 724-6907
Entity
Organization
Contact information
Practice address
1020 MARY ST, UTICA, NY 13501-1930
(315) 724-6907
(315) 797-7249
Mailing address
1020 MARY ST, UTICA, NY 13501-1930
(315) 724-6907
(315) 797-7249
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
011840-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659525582
—
NY
Enumeration date
04/21/2010
Last updated
10/26/2018
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