Organization
ICD INTERNATIONAL CENTER FOR THE DISABLED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LES HALPERT PH.D. (PRESIDENT AND CEO)
(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
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6704100A
NY
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
090110619
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244413
—
NY
01
—
040816000080
FIDELIS CARE NEW YORK
NY
01
—
1054350
BEACON HEALTH STRATEGIES
NY
01
—
3186529
GHI-BMP
NY
01
—
58P0081
NYPRESBY HEALTH PLAN
NY
01
—
A31902
PERFORMAX-MULTIPLAN
NY
01
—
DB5292
RAILROAD RETIREMENT BOARD
NY
Enumeration date
06/11/2007
Last updated
01/04/2013
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