Healthcare Provider Details

I. General information

NPI: 1659240786
Provider Name (Legal Business Name): ICON HEALTH GROUP CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3804 NOSTRAND AVE FL 1
BROOKLYN NY
11235-2013
US

IV. Provider business mailing address

3804 NOSTRAND AVE FL 1
BROOKLYN NY
11235-2013
US

V. Phone/Fax

Practice location:
  • Phone: 917-470-5008
  • Fax:
Mailing address:
  • Phone: 917-470-5008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAMAYUN MALIK
Title or Position: DIRECTOR
Credential:
Phone: 917-470-5008