Healthcare Provider Details

I. General information

NPI: 1730434465
Provider Name (Legal Business Name): DYNAMAIDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 07/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 5TH AVE SUITE 15C
NEW YORK NY
10029-5208
US

IV. Provider business mailing address

1200 5TH AVENUE SUITE 15C
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 917-363-8618
  • Fax:
Mailing address:
  • Phone: 917-363-8618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ALLEN VICTOR BRACKETT
Title or Position: PRESIDENT
Credential: NA
Phone: 917-363-8618