Healthcare Provider Details

I. General information

NPI: 1487807806
Provider Name (Legal Business Name): MR HOMECARE AGENCY OF PA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2008
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 MARKET ST STE 3600
PHILADELPHIA PA
19103-7334
US

IV. Provider business mailing address

1115 OCEAN PKWY, LEVEL C
BROOKLYN NY
11230
US

V. Phone/Fax

Practice location:
  • Phone: 718-338-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARINA RABINOVICH
Title or Position: PRESIDENT
Credential:
Phone: 718-338-6300