Healthcare Provider Details

I. General information

NPI: 1912654021
Provider Name (Legal Business Name): OMEGA HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 BEACH 20TH ST
FAR ROCKAWAY NY
11691-3937
US

IV. Provider business mailing address

19 MARTIN AVE
HEMPSTEAD NY
11550-6305
US

V. Phone/Fax

Practice location:
  • Phone: 516-708-6883
  • Fax:
Mailing address:
  • Phone: 516-708-6883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THERESE NOEL
Title or Position: NP
Credential: NP
Phone: 718-292-0100