Organization
DIGITRACE CARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL R. IBERGER (EVP CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
1983 MARCUS AVE, SUITE E-134, NEW HYDE PARK, NY 11042-1016
(516) 326-0629
(516) 326-0516
Mailing address
200 CORPORATE PL, SUITE 5B, PEABODY, MA 01960-3840
(978) 536-7400
(978) 535-9757
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27782
GHI-HMO
NY
01
—
5503887
GHI PPO
NY
01
—
69644
GHI PPO ALTERNATE
NY
01
—
8011510
CIGNA
NY
01
—
A2590237
OXFORD
NY
01
—
AZ00855
MEDICAL DRS OF NY
NY
01
—
P00865528
RR MEDICARE
NY
Enumeration date
08/17/2006
Last updated
12/21/2011
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