NPI 1558113910

Diverse Ipa INC

Organisation Exclusive Provider Organization Flushing, NY

Practice location

Address: 13229 Blossom Ave Fl 1, Flushing, NY 11355-4915
Phone: (917) 561-0505

Authorised official

Name: Baoli Zhang
Title: President
Phone: (917) 561-0505

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in New York →

Registry record

NPI: 1558113910
Entity type: Organization
NPI issued: 1 Apr 2024
Record last updated: 1 Oct 2024

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.