MEDICARE: PERSONAL TOUCH HOME CARE OF NJ, 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	HP0022005	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851370423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL TOUCH HOME CARE OF NJ, INC

Provider Business Mailing Address
First Line	:	22215 NORTHERN BLVD
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3603
Country	:	US
Telephone Number	:	718-468-4747
Fax Number	:	718-264-5834

Provider Business Practice Location Address
First Line	:	1906 KENNEDY BLVD
Second Line	:	2ND FL
City	:	UNION CITY
State	:	NJ
Zip	:	07087-2013
Country	:	US
Telephone Number	:	201-863-7999
Fax Number	:	201-863-1343

Authorized Official
Title or Position	:	CONTRACT MANAGER
Name	:	LORIGAY LASKIN
Credential	:
Telephone Number	:	718-468-4747

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	07/17/2007

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