Healthcare Provider Details

I. General information

NPI: 1326557901
Provider Name (Legal Business Name): KAIA HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 WALL ST # 5880
NEW YORK NY
10005-4301
US

IV. Provider business mailing address

99 WALL ST # 5880
NEW YORK NY
10005-4301
US

V. Phone/Fax

Practice location:
  • Phone: 630-390-8081
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2278P1005X
TaxonomyPulmonary Rehabilitation Certified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK LIBER
Title or Position: VP BUSINESS DEVELOPMENT
Credential:
Phone: 630-390-8081