Healthcare Provider Details

I. General information

NPI: 1629105846
Provider Name (Legal Business Name): PROFESSIONAL HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 VESTAL PKWY E
VESTAL NY
13850-3514
US

IV. Provider business mailing address

4401 VESTAL PKWY E
VESTAL NY
13850-3514
US

V. Phone/Fax

Practice location:
  • Phone: 607-763-5600
  • Fax: 607-763-5799
Mailing address:
  • Phone: 607-763-5600
  • Fax: 607-763-5799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number023309
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number023309
License Number StateNY

VIII. Authorized Official

Name: MR. JOSEPH E. CERRA
Title or Position: CEO
Credential:
Phone: 607-763-5616