Provider Demographics
NPI:1275665457
Name:NEW YORK NETWORK IPA INC
Entity Type:Organization
Organization Name:NEW YORK NETWORK IPA INC
Other - Org Name:NEW YORK NETWORK MANAGEMENT IPA
Other - Org Type:Other Name
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-748-7316
Mailing Address - Street 1:34 35TH ST STE 4-B517
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2021
Mailing Address - Country:US
Mailing Address - Phone:718-748-7316
Mailing Address - Fax:
Practice Address - Street 1:34 35TH ST STE 4-B517
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2021
Practice Address - Country:US
Practice Address - Phone:718-748-7316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization