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Organization
MINT HEALTH NY LLC
Active
Organization
MINT HEALTH NY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIJAI BLACKWELL (CEO, MEMBER, MANAGER)
(646) 259-5975
Entity
Organization
Contact information
Practice address
41 SAINT NICHOLAS TER APT 54, NEW YORK, NY 10027-2739
(646) 259-5975
Mailing address
41 SAINT NICHOLAS TER APT 54, NEW YORK, NY 10027-2739
(646) 259-5975
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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