Organization
YAI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN ELLENBOGEN (SUPERVISOR OF ASSESSMENTS UNIT)
(212) 273-6100
Entity
Organization
Contact information
Practice address
460 W 34TH ST, NEW YORK, NY 10001-2320
(212) 273-6100
Mailing address
390 SMITH ST, CENTRAL ISLIP, NY 11722-3726
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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