Provider Demographics
NPI:1851980544
Name:EQUIP HEALTH MEDICAL NY PC
Entity Type:Organization
Organization Name:EQUIP HEALTH MEDICAL NY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CLIENT OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFIORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-340-1419
Mailing Address - Street 1:PO BOX 131747
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92013-1747
Mailing Address - Country:US
Mailing Address - Phone:619-350-6290
Mailing Address - Fax:
Practice Address - Street 1:244 MADISON AVE # 1176
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2817
Practice Address - Country:US
Practice Address - Phone:619-350-6290
Practice Address - Fax:619-436-4739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty