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Organization

MILENIA IDS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT KOLMAN (MANAGING MEMBER)
(516) 537-4913
Entity
Organization

Contact information

Practice address
1510 CHESTER PIKE, EDDYSTONE, PA 19022-1375
(516) 537-4913
(516) 537-4910
Mailing address
PO BOX 453, WOODBURY, NY 11797-0453
(516) 537-4913
(516) 537-4910

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
07/25/2017
Last updated
07/25/2017
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