Healthcare Provider Details

I. General information

NPI: 1669288684
Provider Name (Legal Business Name): BLUE HEN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 W MAIN ST
NEWARK DE
19711-3235
US

IV. Provider business mailing address

1904 AVENUE M
BROOKLYN NY
11230-6202
US

V. Phone/Fax

Practice location:
  • Phone: 302-731-5576
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL BRAUNSTEIN
Title or Position: OWNER
Credential:
Phone: 917-751-6685