Healthcare Provider Details

I. General information

NPI: 1922451327
Provider Name (Legal Business Name): MARGRET ULTRA HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 BEACH ST
STATEN ISLAND NY
10304-2702
US

IV. Provider business mailing address

34 BEACH ST
STATEN ISLAND NY
10304-2702
US

V. Phone/Fax

Practice location:
  • Phone: 718-815-8089
  • Fax:
Mailing address:
  • Phone: 718-815-8089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MARGRET UKATU
Title or Position: OWNER
Credential:
Phone: 718-815-8089