Provider Demographics
NPI: | 1770868226 |
---|---|
Name: | AMIDA CARE, INC. |
Entity Type: | Organization |
Organization Name: | AMIDA CARE, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF OPERATING OFFICER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | WILLIAM |
Authorized Official - Last Name: | CRAMER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 646-545-2580 |
Mailing Address - Street 1: | 248 W 35TH ST |
Mailing Address - Street 2: | 7TH FLOOR |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10001-2505 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 646-545-2580 |
Mailing Address - Fax: | 646-786-1801 |
Practice Address - Street 1: | 248 W 35TH ST |
Practice Address - Street 2: | 7TH FLOOR |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10001-2505 |
Practice Address - Country: | US |
Practice Address - Phone: | 646-545-2580 |
Practice Address - Fax: | 646-786-1801 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-10-17 |
Last Update Date: | 2011-10-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 02191582 | 302R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 302R00000X | Managed Care Organizations | Health Maintenance Organization |