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Organization
AMERIGROUP NEW YORK, LLC
Active
Organization
AMERIGROUP NEW YORK, LLC
Active
Other names
AMERIGROUP Community Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER D. HAYTAIAN (PRESIDENT AND CEO)
(212) 563-5570
Entity
Organization
Contact information
Practice address
360 W 31ST ST, 5TH FLOOR, NEW YORK, NY 10001-2727
(212) 563-5570
(212) 563-5975
Mailing address
360 W 31ST ST, 5TH FLOOR, NEW YORK, NY 10001-2727
(212) 563-5570
(212) 563-5975
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
04-008
NY
Other
Enumeration date
12/01/2005
Last updated
07/30/2007
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