Healthcare Provider Details

I. General information

NPI: 1053007096
Provider Name (Legal Business Name): KRISTINA'S HEART TO HEART HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CRESCENT VISCHER FERRY RD APT 505518
HALFMOON NY
12065-7989
US

IV. Provider business mailing address

1400 CRESCENT VISCHER FERRY RD APT 505
HALFMOON NY
12065-7941
US

V. Phone/Fax

Practice location:
  • Phone: 518-512-7604
  • Fax: 518-357-3182
Mailing address:
  • Phone: 518-512-7604
  • Fax: 518-357-3182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KRISTINA M MERGES
Title or Position: OWNER
Credential: DBA
Phone: 518-512-7604