Healthcare Provider Details

I. General information

NPI: 1053707695
Provider Name (Legal Business Name): THERA CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 04/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W 32ND ST FL 8
NEW YORK NY
10001-3212
US

IV. Provider business mailing address

116 W 32 (8 FLOOR)
NEW YORK NY
10001
US

V. Phone/Fax

Practice location:
  • Phone: 212-564-2350
  • Fax: 212-947-7625
Mailing address:
  • Phone: 212-564-2350
  • Fax: 212-947-7625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number577756
License Number StateNY

VIII. Authorized Official

Name: MR. MARCELLO WRIGHT
Title or Position: PROGRAM MANAGER
Credential:
Phone: 18665519700