NPI 1740924687

Im So Yoga

Organisation Preferred Provider Organization Newark, NJ

Practice location

Address: 1186 Raymond Blvd Fl 4, Newark, NJ 07102-4108
Phone: (862) 236-3376
Mailing address: 15 Warren St APT 2, Newark, NJ 07102-3089

Authorised official

Name: Leslie L Hernandez
Title: Ceo
Phone: (862) 236-3376

Registered specialties (5)

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

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Mental Health Clinic/Center (Including Community Mental Health Center)

Ambulatory Health Care Facilities Taxonomy 261QM0801X

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Health Maintenance Organization

Managed Care Organizations Taxonomy 302R00000X

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Point of Service

Managed Care Organizations Taxonomy 305S00000X

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Registry record

NPI: 1740924687
Entity type: Organization
NPI issued: 26 Apr 2022
Record last updated: 26 Apr 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.