Provider Demographics
NPI:1396168696
Name:INTERACTIVE HEALTH NEW YORK LLC
Entity type:Organization
Organization Name:INTERACTIVE HEALTH NEW YORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. RISK MANAGEMENT LAB & SOFTWARE
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KASOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-274-7351
Mailing Address - Street 1:1700 E GOLF RD
Mailing Address - Street 2:STE 900
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5816
Mailing Address - Country:US
Mailing Address - Phone:847-590-0200
Mailing Address - Fax:847-590-0267
Practice Address - Street 1:919 WINTON RD S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-1633
Practice Address - Country:US
Practice Address - Phone:847-590-0200
Practice Address - Fax:847-590-0267
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERACTIVE HEALTH SOLUTIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-23
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty