MEDICARE: HOME HEALTH ASSOCIATES OF NY 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	251E00000X	Home Health Agency	284957	NY

General Provider Information

NPI Number	:	1457886657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME HEALTH ASSOCIATES OF NY LLC

Provider Business Mailing Address
First Line	:	1975 WALTON AVE
Second Line	:	6C
City	:	BRONX
State	:	NY
Zip	:	10453-4700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1975 WALTON AVE
Second Line	:	6C
City	:	BRONX
State	:	NY
Zip	:	10453-4700
Country	:	US
Telephone Number	:	347-634-2447
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. OPEOLUWA O ELEYINAFE
Credential	:	M.D.
Telephone Number	:	347-634-2447

Provider Enumeration Date	:	04/25/2017
Last Update Date	:	04/25/2017

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