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Organization

ALPHA WELLCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MODDY KILUVIA (CEO)
(917) 353-1985
Entity
Organization

Contact information

Practice address
330 E 38TH ST APT 9L, NEW YORK, NY 10016-2765
(917) 916-6419
Mailing address
330 E 38TH ST APT 9L, NEW YORK, NY 10016-2765
(917) 353-1985

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1922073261
NPI
Enumeration date
02/14/2022
Last updated
02/14/2022
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