Healthcare Provider Details

I. General information

NPI: 1063035574
Provider Name (Legal Business Name): FIDELITY HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 01/15/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 FORT HAMILTON PARKWAY 1ST FLOOR
BROOKLYN NY
11219
US

IV. Provider business mailing address

6201 FORT HAMILTON PARKWAY 1ST FLOOR
BROOKLYN NY
11219
US

V. Phone/Fax

Practice location:
  • Phone: 646-688-0335
  • Fax: 718-587-1859
Mailing address:
  • Phone: 646-688-0335
  • Fax: 718-587-1859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. BIYUN CAI
Title or Position: PRESIDENT
Credential:
Phone: 646-688-0335