Basic Information
| Provider Information | |||||||||
| NPI: | 1649410291 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLCARE PROVIDER SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 116 W 32ND ST | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100013212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8773910977 | ||||||||
| FaxNumber: | 2125642578 | ||||||||
| Practice Location | |||||||||
| Address1: | 116 W 32ND ST | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100013212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8773910977 | ||||||||
| FaxNumber: | 2125642578 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2009 | ||||||||
| LastUpdateDate: | 05/05/2009 | ||||||||
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| AuthorizedOfficialLastName: | FEIN | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8773910977 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | Y | Agencies | Case Management |
ID Information
| ID | Type | State | Issuer | Description | 23883 | 01 | NY | NEW YORK STATE DEPARTMENT OF HEALTH | OTHER | 03061070 | 05 | NY | MEDICAID |