Healthcare Provider Details

I. General information

NPI: 1124706197
Provider Name (Legal Business Name): YVONNE B LLEWELLYN HOME HEALTH AIDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RICHARD A GASALBERTI HOME HEALTH AIDE

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7136 110TH ST APT 1L
FOREST HILLS NY
11375-4860
US

IV. Provider business mailing address

17406 110TH AVE # 1A
JAMAICA NY
11433-3456
US

V. Phone/Fax

Practice location:
  • Phone: 718-544-7700
  • Fax: 718-793-2942
Mailing address:
  • Phone: 646-399-4572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number01171244
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: