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General NPI Number Information
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NPI Number | 1003620790
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Entity Type | Organization
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Legal Business Name | PRESTIGE CONCIERGE CARE LLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 11474 225TH ST
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-1228
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Country | US
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Telephone | 516-699-8703
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Fax |
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Provider Business Mailing Address
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Address Line | 11474 225TH ST
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-1228
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Country | US
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Telephone | 516-699-8703
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRISTELLA MEDOZILE
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Credential |
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Telephone | 516-699-8703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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