Provider Demographics
NPI:1710055827
Name:PALLADIA INC
Entity Type:Organization
Organization Name:PALLADIA INC
Other - Org Name:COMPREHENSIVE TREATMENT INSTITUTE OF HARLEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:OKSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARANTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-629-7363
Mailing Address - Street 1:463 FASHION AVE FL 17
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7595
Mailing Address - Country:US
Mailing Address - Phone:646-629-7363
Mailing Address - Fax:855-370-9384
Practice Address - Street 1:177 EAST 122ND STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035
Practice Address - Country:US
Practice Address - Phone:212-360-7116
Practice Address - Fax:212-289-5647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCD010950251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
01291703Medicare UPIN