# DIGITRACE CARE SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396859518
- **Authorized official:** MR. CARL R. IBERGER (EVP CFO)
- **Authorized official phone:** (978) 536-7400

## Contact information

- **Practice address:** 1983 MARCUS AVE, SUITE E-134, NEW HYDE PARK, NY 11042-1016
- **Practice address phone:** (516) 326-0629
- **Practice address fax:** (516) 326-0516
- **Mailing address:** 200 CORPORATE PL, SUITE 5B, PEABODY, MA 01960-3840
- **Mailing address phone:** (978) 536-7400
- **Mailing address fax:** (978) 535-9757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/17/2006
- **Last updated:** 12/21/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 27782 | GHI-HMO | NY |
| 01 | — | 5503887 | GHI PPO | NY |
| 01 | — | 69644 | GHI PPO ALTERNATE | NY |
| 01 | — | 8011510 | CIGNA | NY |
| 01 | — | A2590237 | OXFORD | NY |
| 01 | — | AZ00855 | MEDICAL DRS OF NY | NY |
| 01 | — | P00865528 | RR MEDICARE | NY |