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General NPI Number Information
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NPI Number | 1891827556
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Entity Type | Organization
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Legal Business Name | PORTECK HEALTH NETWORKS
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 260 MADISON AVENUE 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 800-767-6747
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Fax | 800-479-1070
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Provider Business Mailing Address
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Address Line | 260 MADISON AVENUE 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 800-767-6747
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Fax | 800-479-1070
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Authorized Official
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Title or Position | CEO
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Name | MR. ARVIND WALIA
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Credential |
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Telephone | 800-767-6747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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