Healthcare Provider Details

I. General information

NPI: 1578013256
Provider Name (Legal Business Name): DRAGON HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6608 BAY PKWY
BROOKLYN NY
11204-3933
US

IV. Provider business mailing address

6608 BAY PKWY
BROOKLYN NY
11204-3933
US

V. Phone/Fax

Practice location:
  • Phone: 718-666-6977
  • Fax:
Mailing address:
  • Phone: 718-666-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: WAI LUN CHAN
Title or Position: PRESIDENT
Credential:
Phone: 718-666-6977