Healthcare Provider Details

I. General information

NPI: 1083898530
Provider Name (Legal Business Name): MMAGLOIRE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8792 PARSONS BLVD 2ND FLOOR, SUITE 203
JAMAICA NY
11432-3870
US

IV. Provider business mailing address

14039 243RD ST
ROSEDALE NY
11422-2159
US

V. Phone/Fax

Practice location:
  • Phone: 718-262-8600
  • Fax: 718-262-9499
Mailing address:
  • Phone: 718-974-7688
  • Fax: 718-262-9499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1331L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number1331L001
License Number StateNY

VIII. Authorized Official

Name: MS. MARGUERITE MAGLOIRE
Title or Position: DIRECTOR OF PATIENT SERVICES
Credential: RN
Phone: 718-262-8600