Healthcare Provider Details

I. General information

NPI: 1770961393
Provider Name (Legal Business Name): CARE CORE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 06/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 S MAIN ST # 344
NEW CITY NY
10956-3353
US

IV. Provider business mailing address

169 S MAIN ST # 344
NEW CITY NY
10956-3353
US

V. Phone/Fax

Practice location:
  • Phone: 646-450-8455
  • Fax: 646-570-1986
Mailing address:
  • Phone: 646-450-8455
  • Fax: 646-570-1986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: CARLO A. CRESPO
Title or Position: PRESIDENT
Credential:
Phone: 646-450-8455