Provider Demographics
NPI:1386230357
Name:UIA CORPORATION
Entity Type:Organization
Organization Name:UIA CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEYNELL
Authorized Official - Middle Name:DYMOND
Authorized Official - Last Name:DEAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-373-5127
Mailing Address - Street 1:142 WOODWORTH AVENUE
Mailing Address - Street 2:3V
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-2534
Mailing Address - Country:US
Mailing Address - Phone:646-373-5127
Mailing Address - Fax:
Practice Address - Street 1:142 WOODWORTH AVE APT 3V
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-2534
Practice Address - Country:US
Practice Address - Phone:646-373-5127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health