Organization
ICD INTERNATIONAL CENTER FOR THE DISABLED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LES HALPERT PH.D (CEO AND PRESIDENT)
(212) 585-6009
Entity
Organization
Contact information
Practice address
340 E 24TH ST, NEW YORK, NY 10010-4019
(212) 585-6000
(212) 585-6262
Mailing address
340 E 24TH ST, NEW YORK, NY 10010-4019
(212) 585-6000
(212) 585-6262
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
70022112R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244413
—
NY
01
—
040816000080
FIDELIS HEALTHCARE
NY
01
—
58P0081
NY HOSPITAL CHP
NY
01
—
A31902
PERFORMAX-MULTIPLAN
NY
01
—
DB5292
RAILROAD RETIREMENT BD
NY
Enumeration date
11/17/2006
Last updated
08/22/2020
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