Provider Demographics
NPI: | 1154191674 |
---|---|
Name: | CENTER FOR THE INDEPENDENCE OF THE DISABLED IN NEW YORK, INC. |
Entity type: | Organization |
Organization Name: | CENTER FOR THE INDEPENDENCE OF THE DISABLED IN NEW YORK, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHARON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MCLENNON WIER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | , PHD, MSED, CRC |
Authorized Official - Phone: | 646-933-0174 |
Mailing Address - Street 1: | 1010 AVENUE OF THE AMERICAS |
Mailing Address - Street 2: | SUITE #301 |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10080-0023 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-674-2300 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1010 AVENUE OF THE AMERICAS |
Practice Address - Street 2: | SUITE #301 |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10080-0023 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-674-2300 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-01-05 |
Last Update Date: | 2024-01-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251B00000X | Agencies | Case Management |