Healthcare Provider Details

I. General information

NPI: 1689537730
Provider Name (Legal Business Name): HUMANEGDE ALLIED HEALTH, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 GLENN ST STE 401
WHITE PLAINS NY
10603-3252
US

IV. Provider business mailing address

30 GLENN ST STE 401
WHITE PLAINS NY
10603-3252
US

V. Phone/Fax

Practice location:
  • Phone: 914-940-2679
  • Fax: 888-854-9674
Mailing address:
  • Phone: 914-940-2679
  • Fax: 800-854-9674

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: JUAN CARLOS RUIZ
Title or Position: CORPORATER CONTROLLER
Credential:
Phone: 914-940-2679