Healthcare Provider Details

I. General information

NPI: 1134056351
Provider Name (Legal Business Name): PRESTIGE STAFFING AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3930 SETON AVE
BRONX NY
10466-2430
US

IV. Provider business mailing address

3930 SETON AVE
BRONX NY
10466-2430
US

V. Phone/Fax

Practice location:
  • Phone: 914-434-1211
  • Fax:
Mailing address:
  • Phone: 914-434-1211
  • 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: NORMAN MACCULLOCH
Title or Position: CLINICAL DIRECTOR
Credential: PA
Phone: 914-434-1211