MEDICARE: KIRENAGA HOME CARE MANHATTAN INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1093488611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIRENAGA HOME CARE MANHATTAN INC.

Provider Business Mailing Address
First Line	:	575 LEXINGTON AVE FL 4
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-6146
Country	:	US
Telephone Number	:	888-705-1191
Fax Number	:

Provider Business Practice Location Address
First Line	:	575 LEXINGTON AVE FL 4
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-6146
Country	:	US
Telephone Number	:	888-705-1191
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHAWN WALDEN
Credential	:
Telephone Number	:	888-705-1191

Provider Enumeration Date	:	07/29/2021
Last Update Date	:	07/29/2021

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