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Organization

CEREBRAL PALSY TRANSPORT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS MANDELKOW (EXEC VICE PRESIDENT)
(212) 947-5770
Entity
Organization

Contact information

Practice address
5140 59TH ST, WOODSIDE, NY 11377-7413
(718) 205-0708
Mailing address
330 W 34TH ST FL 15, NEW YORK, NY 10001-2406
(212) 947-5770

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00766312
NY
Enumeration date
09/26/2008
Last updated
09/26/2008
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