New Song Ipa LLC
Preferred Provider Organization in New York, NY. Organization (NPI-2).
NPI number1154089340
StatusActive
Last updated in NPPESFeb 2, 2023
Details
- NPI
- 1154089340
- Entity type
- Organization (NPI-2)
- Legal business name
- New Song Ipa LLC
- Organization subpart
- No
- Enumeration date
- Dec 4, 2021
- Certification date
- Feb 2, 2023
- Last updated
- Feb 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | – | – | Yes |
Practice location
885 3rd Ave Fl 29New York, NY 10022-4834
Phone 615-479-5512
Mailing address
885 3rd Ave Fl 29New York, NY 10022-4834
Phone 615-479-5512
Authorized official
Juan Vallarino
Ceo
6154795512
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