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General NPI Number Information
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NPI Number | 1649767344
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Entity Type | Organization
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Legal Business Name | NEW YORK QUALITY HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 2501 JACKSON AVE
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-5095
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Country | US
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Telephone | 888-343-3547
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 FORSYTH BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63105-1813
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP, ASSOCIATE GENERAL COUNSEL
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Name | KENNETH KOSHOREK
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Credential |
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Telephone | 313-720-5567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | C029339
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License Number State | NY
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