1619005774 NPI number — INTER-CARE LTD

Table of content: (NPI 1619005774)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619005774 NPI number — INTER-CARE LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTER-CARE LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619005774
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51 E 25TH ST
Provider Second Line Business Mailing Address:
LOWER LEVEL
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10010-2945
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-532-0303
Provider Business Mailing Address Fax Number:
212-532-9225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51 E 25TH ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10010-2945
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-532-0303
Provider Business Practice Location Address Fax Number:
212-532-9225
Provider Enumeration Date:
03/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LESSA
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
212-532-0303

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 089660 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 20566 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 002788 . This is a "EMPIRE BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: A478610 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01358745 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 006537 . This is a "MHN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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