Healthcare Provider Details

I. General information

NPI: 1336293232
Provider Name (Legal Business Name): LONG ISLAND CARE AT HOME LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 OLD COUNTRY ROAD SUITE 108
WESTBURY NY
11590-5119
US

IV. Provider business mailing address

1400 OLD COUNTRY ROAD SUITE 108
WESTBURY NY
11590-5119
US

V. Phone/Fax

Practice location:
  • Phone: 516-794-0700
  • Fax: 516-794-0787
Mailing address:
  • Phone: 516-794-0700
  • Fax: 516-794-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number9376L001
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number9376L001
License Number StateNY

VIII. Authorized Official

Name: MARYANN C OSBORNE
Title or Position: V PRES
Credential:
Phone: 516-794-0700