Organization
NICKJAX LLC
Active
Other names
LearningRx
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD MANCUSO (EXECUTIVE DIRECTOR)
(212) 738-9264
Entity
Organization
Contact information
Practice address
115 E 82ND ST, 1B, NEW YORK, NY 10028-0831
(212) 738-9264
Mailing address
115 E 82ND ST, 1B, NEW YORK, NY 10028-0831
(212) 738-9264
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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