Upstate Cerebral Palsy

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Marcy, NY

NPI 1376604371 · NPPES record last updated Apr 5, 2023

Key facts

NPI
1376604371
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
01332796 (NY)
Legal business name
UPSTATE CEREBRAL PALSY
Practice address
9592 Hayes Rd
Marcy, NY 13403-2606
Phone
(315) 768-1007
Fax
(315) 768-1067
NPI assigned
Dec 13, 2006
Organization subpart
No

Authorized official

Name
Geno Decondo
Title
Executive Director
Phone
(315) 927-2092

Corporate family (same tax ID) 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Upstate Cerebral Palsy Inc (29 organizations share this tax ID)

Locations

9592 Hayes Rd
Marcy, NY 13403
Phone (315) 768-1007

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 01332796 NY Yes

Addresses

Primary practice location

9592 Hayes Rd
Marcy, NY 13403-2606

Mailing address

125 Business Park Dr
Utica, NY 13502-6305
Phone (315) 724-6907

Other identifiers

IdentifierTypeStateIssuer
01332796MedicaidNY

Other providers in Marcy, NY

All providers in Marcy, NY · Intellectual Disabilities Intermediate Care Facility in New York

Sources for this page

Verify at the official NPI Registry.