Healthcare Provider Details

I. General information

NPI: 1972440063
Provider Name (Legal Business Name): AFFINITY CARE OF WISCONSIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 AVENUE Z STE 201
BROOKLYN NY
11235-3083
US

IV. Provider business mailing address

2102 AVENUE Z STE 201
BROOKLYN NY
11235-3083
US

V. Phone/Fax

Practice location:
  • Phone: 646-585-2175
  • Fax:
Mailing address:
  • Phone: 646-585-2175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL STERN
Title or Position: CEO
Credential:
Phone: 510-499-9977