Provider Demographics
NPI:1487906707
Name:CENTERFORDISABILTYSERVICES
Entity type:Organization
Organization Name:CENTERFORDISABILTYSERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:RITMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-437-5820
Mailing Address - Street 1:5 KELLER ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3513
Mailing Address - Country:US
Mailing Address - Phone:518-437-5920
Mailing Address - Fax:518-437-5975
Practice Address - Street 1:5 KELLER STREET
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205
Practice Address - Country:US
Practice Address - Phone:518-437-5820
Practice Address - Fax:518-437-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142943-1305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization