Organization
IDUHA IPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MUIR (EXECUTIVE DIRECTOR)
(718) 637-3045
Entity
Organization
Contact information
Practice address
307 W 38TH ST, NEW YORK, NY 10018-2913
(718) 637-3045
Mailing address
307 W 38TH ST, ROOM 03-049, NEW YORK, NY 10018-2913
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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