Organization
CATHOLIC MANAGED LTC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MICHAEL SHAW (REGISTERED NURSE)
(914) 355-6744
Entity
Organization
Contact information
Practice address
205 LEXINGTON AVE, NEW YORK, NY 10016-6022
(646) 395-5908
Mailing address
205 LEXINGTON AVE, NEW YORK, NY 10016-6022
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
02/22/2016
Last updated
02/22/2016
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