Healthcare Provider Details

I. General information

NPI: 1952257933
Provider Name (Legal Business Name): CANID IPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 5TH AVE RM 1011
NEW YORK NY
10001-0611
US

IV. Provider business mailing address

276 5TH AVE RM 1011
NEW YORK NY
10001-0611
US

V. Phone/Fax

Practice location:
  • Phone: 646-338-4943
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PEDRO SANCHEZ DE LOZADA
Title or Position: CEO
Credential:
Phone: 646-338-4943