Healthcare Provider Details

I. General information

NPI: 1881167732
Provider Name (Legal Business Name): LUBA'S HOMECARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E 57TH ST APT 2J
NEW YORK NY
10022-2691
US

IV. Provider business mailing address

220 E 57TH ST APT 2J
NEW YORK NY
10022-2691
US

V. Phone/Fax

Practice location:
  • Phone: 646-882-9990
  • Fax: 855-525-2020
Mailing address:
  • Phone: 646-882-9990
  • Fax: 855-525-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LIUBOV BRIZHATIUK
Title or Position: ADMINISTRATOR
Credential:
Phone: 917-607-0040