Provider Demographics
NPI:1417327016
Name:MEDICASAFE, INC.
Entity Type:Organization
Organization Name:MEDICASAFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-661-2537
Mailing Address - Street 1:131 VARICK ST
Mailing Address - Street 2:SUITE 934
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-1410
Mailing Address - Country:US
Mailing Address - Phone:646-612-7653
Mailing Address - Fax:646-349-3796
Practice Address - Street 1:131 VARICK ST
Practice Address - Street 2:SUITE 934
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1410
Practice Address - Country:US
Practice Address - Phone:646-612-7653
Practice Address - Fax:646-349-3796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty