Healthcare Provider Details

I. General information

NPI: 1235762865
Provider Name (Legal Business Name): PROLIFIC HOME HEALTH ASSESSORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

796 SARATOGA AVE STE A
BROOKLYN NY
11212-4475
US

IV. Provider business mailing address

796 THOMAS S BOYLAND ST
BROOKLYN NY
11212-4433
US

V. Phone/Fax

Practice location:
  • Phone: 347-365-9779
  • Fax: 347-365-4230
Mailing address:
  • Phone: 347-951-4301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: PRISCILLA NNENNA ORJI
Title or Position: CEO
Credential:
Phone: 347-951-4301