Provider Demographics
NPI:1629041488
Name:HEALTH INSURANCE PLAN OF GREATER NY
Entity Type:Organization
Organization Name:HEALTH INSURANCE PLAN OF GREATER NY
Other - Org Name:CENTRALIZED LABORATORY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-269-1627
Mailing Address - Street 1:4325 HUNTER ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4212
Mailing Address - Country:US
Mailing Address - Phone:718-786-6376
Mailing Address - Fax:
Practice Address - Street 1:4325 HUNTER ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4212
Practice Address - Country:US
Practice Address - Phone:718-786-6376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY51385Medicare ID - Type Unspecified