Healthcare Provider Details

I. General information

NPI: 1649842741
Provider Name (Legal Business Name): AMSTERDAM HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1242 E 80TH ST APT 3
BROOKLYN NY
11236-4160
US

IV. Provider business mailing address

1242 E 80TH ST APT 3
BROOKLYN NY
11236-4160
US

V. Phone/Fax

Practice location:
  • Phone: 347-342-7432
  • Fax:
Mailing address:
  • Phone: 347-342-7432
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TYRONE A BLACKBURN
Title or Position: MANAGING MEMBER
Credential:
Phone: 347-342-7432