Organization
NEW YORK STATE CATHOLIC HEALTH PLAN, INC.
Active
Other names
Fidelis Care New York
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L LANE (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(718) 896-6500
Entity
Organization
Contact information
Practice address
9525 QUEENS BLVD, 8TH FL, REGO PARK, NY 11374-4510
(718) 896-6500
(718) 896-2755
Mailing address
9525 QUEENS BLVD, 8TH FL, REGO PARK, NY 11374-4510
(718) 896-6500
(718) 896-2755
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
C-027194
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C-027194
—
NY
Enumeration date
10/14/2011
Last updated
10/28/2011
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