Organization
INDEPENDENCE CARE SYSTEM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS GOGGIN-CALLAHAN JD (VICE PRESIDENT, COMPLIANCE)
(646) 653-6142
Entity
Organization
Contact information
Practice address
25 ELM PL FL 5, BROOKLYN, NY 11201-5826
(212) 584-2500
Mailing address
257 PARK AVE S, NEW YORK, NY 10010-7304
(646) 653-6142
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01865329
—
NY
Enumeration date
09/06/2018
Last updated
09/06/2018
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