MEDICARE: PRESTIGE CARE LLC

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1356115133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE CARE LLC

Provider Business Mailing Address
First Line	:	36 TREMONT TER
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3710
Country	:	US
Telephone Number	:	973-943-2494
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 TREMONT TER
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-3710
Country	:	US
Telephone Number	:	973-943-2494
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MISS SANDRA NKUCHE
Credential	:	MD
Telephone Number	:	973-943-2494

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	06/24/2026

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Directions to “PRESTIGE CARE LLC ” Practice Location

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