Organization
CINQ-NY HEALTH HOME IPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM A HAGAN (CHIEF OPERATING OFFICER)
(602) 920-5231
Entity
Organization
Contact information
Practice address
564 NIAGARA ST BLDG 2, BUFFALO, NY 14201-1108
(716) 247-5282
Mailing address
6536 E GREYTHORN DR, SCOTTSDALE, AZ 85266-6761
(602) 920-5231
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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