Please send our office the completed application, along with the W-9, and supplementary documents listed on page 1 of the application.
Once completed, this package can be emailed, faxed, or mailed to our office.
Contact
Bronx United IPA
140 Wadsworth Ave., Suite 4
New York, NY 10033
providerrelations@unitedipas.com
Phone: (646) 417-0500
Fax: (212) 320-0597