Provider Demographics
NPI:1679941918
Name:CHELTON LOFT
Entity type:Organization
Organization Name:CHELTON LOFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-727-4275
Mailing Address - Street 1:104-106 EAST 126TH ST
Mailing Address - Street 2:SUITE 4D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035
Mailing Address - Country:US
Mailing Address - Phone:212-727-4360
Mailing Address - Fax:
Practice Address - Street 1:104-106 EAST 126TH ST
Practice Address - Street 2:SUITE 4D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035
Practice Address - Country:US
Practice Address - Phone:212-727-4360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FEDCAP REHABILITATION SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health