Organization
CENTERLIGHT HEALTHCARE, INC.
Active
Other names
Direct Total MAP
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN LIBERTI (VP. PROVIDER RELATIONS)
(917) 828-7701
Entity
Organization
Contact information
Practice address
13665 37TH AVE, FLUSHING, NY 11354-4110
(833) 252-2737
Mailing address
13665 37TH AVE, FLUSHING, NY 11354-4110
(833) 252-2737
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03171946
—
NY
Enumeration date
12/29/2009
Last updated
09/06/2024
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