Provider Demographics
NPI:1497979249
Name:CATHOLIC SPECIAL NEEDS PLAN LLC
Entity Type:Organization
Organization Name:CATHOLIC SPECIAL NEEDS PLAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-752-7300
Mailing Address - Street 1:1339 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4707
Mailing Address - Country:US
Mailing Address - Phone:212-752-7300
Mailing Address - Fax:
Practice Address - Street 1:1339 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4707
Practice Address - Country:US
Practice Address - Phone:212-752-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
H1777OtherCMS PLAN CONTRACT NUMBER