DIVERSE IPA INC

FLUSHING, NY
NPI1558113910
Entity TypeOrganization
Authorized ContactBAOLI ZHANG
President
917-561-0505
Organization Subpart ?No
Primary Taxonomy302F00000X Exclusive Provider Organization
Enumeration Date2024-04-01
Last Update Date2024-10-01
Business Address
DIVERSE IPA INC
13229 BLOSSOM AVE FL 1
FLUSHING, NY 11355-4915
Phone number: 917-561-0505
Mailing Address
DIVERSE IPA INC
13229 BLOSSOM AVE FL 1
FLUSHING, NY 11355-4915
Phone number:
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