Provider Demographics
NPI:1609941517
Name:INNOVATIVE THERAPEUTICS,LLC
Entity Type:Organization
Organization Name:INNOVATIVE THERAPEUTICS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-643-0406
Mailing Address - Street 1:515 BROADWAY
Mailing Address - Street 2:SUITE - 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-4449
Mailing Address - Country:US
Mailing Address - Phone:212-643-0406
Mailing Address - Fax:212-219-0219
Practice Address - Street 1:515 BROADWAY
Practice Address - Street 2:SUITE - 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4449
Practice Address - Country:US
Practice Address - Phone:212-643-0406
Practice Address - Fax:212-219-0219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19280251300000X, 251B00000X, 251C00000X, 251E00000X, 251G00000X, 251J00000X, 251K00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251300000XAgenciesLocal Education Agency (LEA)
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251E00000XAgenciesHome Health
Not Answered251G00000XAgenciesHospice Care, Community Based
Not Answered251J00000XAgenciesNursing Care
Not Answered251K00000XAgenciesPublic Health or Welfare
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY19280OtherARTICLE 25