Organization
CCN -WNY IPA LLC
Active
Parent organization
EVICORE
Other names
New York Health Care Providers IPA LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVICORE
Authorized official
MR. RICHARD W. KAPLAN (SENIOR VICE PRESIDENT)
(914) 251-0300
Entity
Organization
Contact information
Practice address
4 GREENWICH OFFICE PARK, FLOOR 2, GREENWICH, CT 06831-5153
(914) 251-0300
Mailing address
4 GREENWICH OFFICE PARK, FLOOR 2, GREENWICH, CT 06831-5153
(914) 251-0300
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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