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General NPI Number Information
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NPI Number | 1295369023
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Entity Type | Organization
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Legal Business Name | DIABETICWATCHERS USA LLC
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 315 W 36TH ST
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City | NEW YORK
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State | NY
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Zip | 10018-6404
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Country | US
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Telephone | 844-277-5066
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Fax |
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Provider Business Mailing Address
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Address Line | 30 GALESI DR STE 104B
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City | WAYNE
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State | NJ
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Zip | 07470-4840
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Country | US
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Telephone | 201-577-8994
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Fax |
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Authorized Official
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Title or Position | PROGRAM COORDINATOR
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Name | MS. MILA CORRAO
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Credential |
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Telephone | 201-577-8994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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Taxonomy #4
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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Taxonomy #5
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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Taxonomy #6
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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Taxonomy #7
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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