Healthcare Provider Details

I. General information

NPI: 1174481543
Provider Name (Legal Business Name): INCLUSIVE INSURANCE AGENCY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 01/13/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3418 NORTHERN BLVD FL 4 #45
LONG ISLAND CITY NY
11101-2236
US

IV. Provider business mailing address

3418 NORTHERN BLVD FL 4 #45
LONG ISLAND CITY NY
11101-2236
US

V. Phone/Fax

Practice location:
  • Phone: 646-334-1143
  • Fax:
Mailing address:
  • Phone: 646-334-1143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: EMILIA TAVAREZ
Title or Position: PRINCIPAL AND FOUNDER
Credential: CMIP
Phone: 646-334-1143