Provider Demographics
NPI:1073038170
Name:INFORMED DATA SYSTEMS, INC.
Entity Type:Organization
Organization Name:INFORMED DATA SYSTEMS, INC.
Other - Org Name:ONE DROP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP CLINICAL OPERATIONS & INNOVATION
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-461-9295
Mailing Address - Street 1:85 DELANCEY ST STE 71
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3182
Mailing Address - Country:US
Mailing Address - Phone:858-461-9295
Mailing Address - Fax:
Practice Address - Street 1:85 DELANCEY ST STE 71
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3182
Practice Address - Country:US
Practice Address - Phone:858-461-9295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty