Organization
UPSTATE CEREBRAL PALSY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENO DECONDO (EXECUTIVE DIRECTOR)
(315) 927-2092
Entity
Organization
Contact information
Practice address
2382 BLEECKER ST, FRANKFORT, NY 13340-4811
(315) 735-1993
(315) 735-1963
Mailing address
1020 MARY ST, UTICA, NY 13501-1930
(315) 724-6907
(315) 733-0791
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
01295954
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01295954
—
NY
Enumeration date
12/13/2006
Last updated
09/13/2018
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