Provider Demographics
NPI:1245285774
Name:NY UNITED HEALTHCARE,LTD
Entity type:Organization
Organization Name:NY UNITED HEALTHCARE,LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-375-6001
Mailing Address - Street 1:445 KINGS HIGHWAY
Mailing Address - Street 2:2 FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223
Mailing Address - Country:US
Mailing Address - Phone:718-375-6001
Mailing Address - Fax:718-375-6177
Practice Address - Street 1:445 KINGS HWY
Practice Address - Street 2:2 FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1780
Practice Address - Country:US
Practice Address - Phone:718-375-6001
Practice Address - Fax:718-375-6177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237360207RC0000X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEH041Medicare PIN
NYWEH042Medicare PIN