Amerigroup New York, LLC
Health Maintenance Organization in New York, NY. Organization (NPI-2).
NPI number1649254806
StatusActive
Last updated in NPPESJul 30, 2007
Details
- NPI
- 1649254806
- Entity type
- Organization (NPI-2)
- Legal business name
- Amerigroup New York, LLC
- Organization subpart
- No
- Enumeration date
- Dec 1, 2005
- Last updated
- Jul 30, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302R00000X | Health Maintenance Organization | 04-008 | NY | Yes |
Other names
- Amerigroup Community Care (Doing Business As)
Practice location
360 W 31st St5th Floor
New York, NY 10001-2727
Phone 212-563-5570 · Fax 212-563-5975
Mailing address
360 W 31st St5th Floor
New York, NY 10001-2727
Phone 212-563-5570 · Fax 212-563-5975
Authorized official
Peter D. Haytaian
President And Ceo
2125635570
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