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Organization
INTREPID OF NEW YORK INC
Active
Organization
INTREPID OF NEW YORK INC
Active
Other names
Intrepid USA Healthcare Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL D FOSTER (CEO)
(214) 445-3750
Entity
Organization
Contact information
Practice address
212-47 JAMAICA AVE, 2ND FLOOR, SUITE 209, QUEENS VILLAGE, NY 11428-1632
(718) 776-7760
(718) 776-7884
Mailing address
4055 VALLEY VIEW LN, 5TH FLOOR, DALLAS, TX 75244-5074
(214) 445-3750
(214) 445-3902
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1067L002
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02517095
—
NY
Enumeration date
11/18/2005
Last updated
04/20/2016
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