Healthcare Provider Details

I. General information

NPI: 1467074898
Provider Name (Legal Business Name): MARQUIS CERTIFIED HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 CENTRAL AVE
ALBANY NY
12205-4773
US

IV. Provider business mailing address

230 N MAIN ST
SPRING VALLEY NY
10977-4020
US

V. Phone/Fax

Practice location:
  • Phone: 518-216-0100
  • Fax:
Mailing address:
  • Phone: 845-363-8140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ARYEH GORELICK
Title or Position: CONTROLLER
Credential: CPA
Phone: 845-241-9724