Healthcare Provider Details

I. General information

NPI: 1215135421
Provider Name (Legal Business Name): GREATER NEW YORK HOME HEALTH SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17520 WEXFORD TER
JAMAICA NY
11432-2872
US

IV. Provider business mailing address

17520 WEXFORD TER
JAMAICA NY
11432-2872
US

V. Phone/Fax

Practice location:
  • Phone: 718-526-9882
  • Fax: 718-526-9895
Mailing address:
  • Phone: 718-526-9882
  • Fax: 718-526-9895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number9353L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number9353L001
License Number StateNY

VIII. Authorized Official

Name: MR. SANYALE JONES
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential: MPH
Phone: 917-864-1233