NPI 1124232939

Corinthian Medical Ipa

Organisation Exclusive Provider Organization New York, NY

Practice location

Address: 481 Fort Washington Ave, New York, NY 10033-4654
Phone: (212) 740-8294
Fax: (212) 740-8289

Authorised official

Name: Ramon Modesto Tallaj
Title: President
Phone: (212) 740-8294

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1124232939
Entity type: Organization
NPI issued: 10 May 2007
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.